Bunions

A bunion, or painful bony bump near the big toe, can make it hard to wear shoes and walk. At Atrium Health Floyd and Harbin Clinic, our orthopedic specialists provide nonsurgical and surgical bunion treatments that improve how your foot looks and feels.

What is a bunion?

A bunion is a bony bump that forms at the base of the big toe. You may have a bunion on one foot or both feet. The bump might be unsightly as well as painful.

Causes of bunions

Bunions form gradually when excess pressure on a big toe joint pushes the big toe toward the second toe (also called the index or pointer toe). Persistent pressure changes the positions of bones, tendons and ligaments in the big toe and foot. Over time, extra bone and a fluid-filled sac form at the base of the big toe, creating a bunion.

Actions that can put pressure on the big toe and cause a bunion include:

• Standing or working on your feet for long periods
• Walking in an unusual manner, such as when your feet roll inward (overpronation)
• Wearing shoes that don’t fit properly – especially shoes with narrow, pointed toe boxes

Bunion symptoms

A bunion looks like a small bump. It forms on the inside of the foot at the base of the big toe. In addition to a bony bump, you may have:

• Big toe that turns toward, or crosses over, the second toe
• Corns or calluses (thickened skin) where the big toe and second toe meet
• Difficulty walking due to foot pain
• Pain that worsens when you wear shoes, walk or put pressure on the bump
• Red, thickened skin along the inside edge at the base of the big toe
• Tight, painful toe tendons and joints that make it hard to bend the toe

Bunion types

Bunions usually form at the base of the big toe. But bunions can affect other toes, too, and occur for different reasons. Types of bunions include:

• Congenital bunions, which are present at birth
• Juvenile (adolescent) bunions, which affect people younger than 18. This type can be painful but is less likely to affect how well you can move the big toe.
• Tailor’s bunions (bunionettes), which form at the base of the little (pinky) toe

Bunion diagnosis

Your health care provider can diagnose a bunion by looking at your foot. You may also get a foot X-ray, which can show:

• Bone alignment
• Severity of the bunion
• Signs of arthritis or damage to toe joints

Bunion risk factors

Certain factors can increase your chances of developing a bunion, including:

• Female sex assigned at birth
• Foot injuries
• Inherited foot shape and structure, such as flat feet or high arches
• Joint problems, such as rheumatoid arthritis
• Neuromuscular disorders, such as polio
• Obesity

Complications of bunions

A bunion can increase your risk of complications such as:

• Bursitis
• Hammertoe
• Loss of mobility, which can lead to weight gain
• Osteoarthritis

Bunion prevention

Because foot structure plays a role in the formation of bunions, you can’t always prevent them. Still, some actions may help prevent a bunion or keep a small bunion from getting worse. Some things that can help prevent bunions include:

• Applying bunion pads or foam cushions to existing bunions
• Choosing shoes made with flexible, stretchy canvas or leather material with wide toe boxes
• Limiting how often you wear shoes with high heels
• Maintaining a healthy weight
• Placing toe separators between your big toe and second toe
• Wearing shoe inserts (orthotics) if you have structural foot problems

Bunion treatments

A surgical procedure to remove the bunion (bunionectomy) may be necessary if the bunion gets too large and painful or affects your ability to walk. Physical therapy after surgery can help you regain mobility.