Foot Health Bunions An Overview of Bunions By Catherine Moyer, DPM Catherine Moyer, DPM, is a podiatrist experienced in the diagnosis, treatment, and prevention of disorders of the foot and ankle. Learn about our editorial process Catherine Moyer, DPM Medically reviewed by Medically reviewed by Kashif J. Piracha, MD on September 24, 2020 facebook twitter linkedin Kashif J. Piracha, MD, is board-certified in internal medicine and nephrology. He has an active clinical practice at Methodist Willowbrook Hospital in Houston, Texas. Learn about our Medical Review Board Kashif J. Piracha, MD on September 24, 2020 Print Table of Contents View All Symptoms Causes Diagnosis Treatment A bunion—also known as hallux valgus—is a bony protrusion that typically juts out from the side of the big toe. Less commonly, a bunion may form next to the small toe, and this is referred to as a "bunionette" or "tailor's bunion." Several factors—some of which can be controlled, some of which can't—make a person more vulnerable to developing bunions. A doctor can usually diagnose a bunion simply by looking at your foot. Most of the time bunions are treated conservatively with self-care strategies, but surgery may be indicated in some cases. Illustration by Alexandra Gordon, Verywell Symptoms If bunion symptoms do occur, they usually develop over time, well after the bump has formed. Symptoms may include one or more of the following: Soreness and/or a burning sensation over the bunionRedness, stiffness, and swelling around the big toe jointHammertoes or calluses under the ball of the footCorns or other skin irritations where the first and second toes overlap What Does a Bunion Look Like? Causes While the precise cause behind bunion formation has not been completely sorted out, experts believe that certain foot types make a person more prone to developing bunions, and these foot types tend to run in families. More specifically, experts suspect that a combination of a certain foot type, along with years of abnormal pressure over the big toe joint (called the first metatarsophalangeal joint), is what commonly leads to bunion formation. In particular, wearing shoes that crowd the toes together is a common culprit. This is, in part, why women tend to develop bunions more than men; many women's shoes have narrow toe boxes. High heels can make matters worse by forcing the toes even deeper into the narrowed tip. The Price of Wearing High Heels Besides narrow footwear and an inherited foot type, other factors that may contribute to bunion formation include: Flat feet or low archesFoot injury or traumaInflammatory arthritis of the foot, like rheumatoid arthritisNeuromuscular conditions, like cerebral palsyGenetic disorders, such as Ehlers-Danlos syndrome or Down syndrome Causes of Bunions Illustration by Brianna Gilmartin, Verywell Diagnosis The diagnosis of a bunion can be made by physical exam alone, as this bony deformity is visible to the naked eye. That said, to fully access the bunion and big toe joint, your doctor may order an X-ray. 5 Causes of Big Toe Joint Pain Treatment Treatment of a bunion is only required if it is causing symptoms. While there are numerous non-surgical treatment options available, if bunion symptoms are severe or persistent, then surgery to correct the misalignment may be considered. Self-Care Strategies When dealing with acute bunion pain, these self-care strategies may give you some relief: Remove your shoes and elevate your feet to relieve some of the pressure and inflammation.Apply an ice pack if the pain and swelling are extreme (aim for several 10- to 15-minute sessions a day). Be sure to move the ice pack around and place a thin towel between the pack and your skin.Soak your feet in cool (not ice) water to reduce swelling. Use a warm foot bath or a moist, steamed towel if you're experiencing big toe joint stiffness.Stretch your feet with a simple set of routine exercises to keep the foot flexible and avoid stiffness. Medications To ease the pain of a bunion, your doctor may recommend taking an over-the-counter anti-inflammatory medication, like Advil (ibuprofen). Less commonly, your doctor may inject a steroid (cortisone) into the bursa (the sac surrounding the big toe joint) to relieve inflammation. Shoe Inserts If you have a painful bunion, you can relieve some of the pain by either padding the bunion from the outside or forcing the toes into a more natural position. Bunion pads are readily available at most drugstores and are made either of moleskin, neoprene, foam, silicone, or a gel-filled plastic. They lessen the pressure placed on the bunion while wearing shoes and tend to work best when wearing shoes with a wide toe box. While most bunion pads are applied with a removable adhesive strip, others are woven into the fabric of removal booties. Toe spacers, as per their name, are placed between your toes. Most are made of contoured foam or plastic. While some only open the space between the big toes, newer, glove-like models are constructed of neoprene and separate all five toes. Among the variety of bunion relief appliances, there are night splints that can gradually correct the toe alignment and even slip-on inserts that combine a bunion pad with individual toe separators. Proper Footwear Even if the shoes you wear have low heels and a square foot box, they may not fit properly. Many foot problems arise simply because of choosing fashion over comfort and support. While you may think you know your correct size, manufacturer sizes can vary enormously, leaving you swimming in some shoes and barely able to put on others. Moreover, your shoe size can change as you age since the vertical pressure placed on your feet can, over time, cause the bones and cartilage to flatten and spread. To prevent or correct a foot problem, get your feet correctly measured every five years or so. A specialty running shoe store is a great place to get your feet measured, as these retailers are likely to conduct a comprehensive foot evaluation. This not only involves the sizing your foot but an assessment of your foot alignment and arch. The evaluation can give you insight about what type of shoe is best for you, including whether you need custom orthotics or arch supports. The better your shoes fit, the less likely your toes will slip forward and become compressed. If searching for the right shoe to treat bunion pain, always look for the following features: A toe box large enough to wiggle and spread your toesA heel no higher than one to two inchesMalleable shoe material, such as canvas or a soft leatherEnough interior space to insert bunion pads or insolesA moderately flexible sole (as opposed to a hard or flimsy sole) The Best Shoes for Bunions Physical Therapy Some podiatrists refer their patients to a physical therapist who specializes in treating foot conditions. To ease inflammation and bunion pain, your physical therapist may use ultrasound therapy. Surgery If your bunion pain is severe or persistent and/or diminishing your overall daily functioning/quality of life, it's sensible to discuss surgery with your doctor. The goals of bunion-reducing surgery are to alleviate bunion pain and deformity. Depending on various factors like your age, activity level, and the severity of your bunion, your surgeon will choose one of many surgical procedures, including osteotomy (bone realignment), arthrodesis (joint fusion), resectional arthroplasty (removal of the damaged joint), or exostectomy (removal of the bunion bump only). Exostectomy is rarely performed alone; since it does not realign the big toe joint, the bunion often recurs. An Overview of Bunion Surgery If you are uncertain as to whether surgery is right for you, consider asking your foot and ankle surgeon these questions: What are the risks and benefits of the treatment?What results can I expect?What is involved in recovery?How is post-operative pain managed? These responses, along with the cost of the recommended procedure, can help you make an informed choice. A Word from Verywell A bunion, albeit common, can be a frustrating foot condition to deal with. However, with the right self-care strategies and some diligence on your part, most people can manage their bunion(s) well. That said, if you are not obtaining relief with simple measures or your bunions are affecting your mobility or daily quality of life, be sure to talk with your doctor about next steps. Surgery may be a sensible option for you at this point. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 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Efficacy of Foot and Ankle Corticosteroid Injections. Foot Ankle Int. 2017;38(1):8-13. Tehraninasr A, Saeedi H, Forogh B, Bahramizadeh M, Keyhani MR. Effects of insole with toe-separator and night splint on patients with painful hallux valgus: a comparative study. Prosthet Orthot Int. 2008;32(1):79-83. Branthwaite H, Chockalingam N, Greenhalgh A. The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females. J Foot Ankle Res. 2013;6:28. Published 2013 Jul 25. doi:10.1186/1757-1146-6-28 Boulton AJ, Armstrong DG, Albert SF, et al. Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008;31(8):1679–1685. doi:10.2337/dc08-9021 Menz HB. Foot orthoses: how much customisation is necessary?. J Foot Ankle Res. 2009;2:23. Published 2009 Jul 9. doi:10.1186/1757-1146-2-23 Mortka K, Lisiński P. Hallux valgus-a case for a physiotherapist or only for a surgeon? Literature review. J Phys Ther Sci. 2015;27(10):3303–3307. doi:10.1589/jpts.27.3303 Meyr AJ, Singh S, Chen O, Ali S. A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgus. J Radiol Case Rep. 2015;9(6):29–43. Published 2015 Jun 30. doi:10.3941/jrcr.v9i6.2142 Additional Reading American Podiatric Medical Association. (2019). Bunions. https://www.apma.org/Patients/FootHealth.cfm?ItemNumber=979 Dini M. Podiatric Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2019 New York, NY: McGraw-Hill; http://accessmedicine.mhmedical.com/content.aspx?bookid=2449§ionid=194443900. Ferrari J (2017). Hallux valgus deformity (bunion). Eiff P, Asplund CA, eds. UpToDate. Waltham, MA: UpToDate Inc. Hern, S.; Vicenzino, B.; and Smith, M. Non-surgical treatment of hallux valgus: a current practice survey of Australian podiatrists. J Foot Ankle Res. 2016;9:16. DOI: 10.1186/s13047-016-0146-5. MacDonald, A.; Houck, J.; and Baumhauer, J. The Road to Recovery for Bunion Surgery. Foot Ankle Orthoped. 2017. DOI: 10.1177/2473011417S000275.