An Overview of Bunions
Medically reviewed by Kashif J. Piracha, MD
A bunion is a bony protrusion that typically juts out from the side of the big toe. It is associated with a condition, known as hallux valgus, where the big toe points inward toward the second 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 healthcare provider 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.
Verywell / Alexandra Gordon
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 bunion
Redness, stiffness, and swelling around the big toe joint
Hammertoes or calluses under the ball of the foot
Corns or other skin irritations where the first and second toes overlap
Related: Visual Features of a Bunion
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.
Related: 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 arches
Foot injury or trauma
Inflammatory arthritis of the foot, like rheumatoid arthritis
Neuromuscular conditions, like cerebral palsy
Genetic disorders, such as Ehlers-Danlos syndrome or Down syndrome
Learn More: Causes of Bunions
Verywell / Brianna Gilmartin
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 healthcare provider may order an X-ray.
Related: 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 healthcare provider may recommend taking an over-the-counter anti-inflammatory medication, like Advil (ibuprofen).
Less commonly, your healthcare provider 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.
Key features
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 toes
A heel no higher than one to two inches
Malleable shoe material, such as canvas or a soft leather
Enough interior space to insert bunion pads or insoles
A moderately flexible sole (as opposed to a hard or flimsy sole)
Related: 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 healthcare provider. The goals of bunion-reducing surgery are to alleviate bunion pain and deformity. Surgery may be done to help realign the toe joint and restore function (hallux valgus surgery).
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.
Learn More: 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.
Related: Is Physical Therapy Needed After Bunion Surgery?
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 healthcare provider about next steps. Surgery may be a sensible option for you at this point.
Frequently Asked Questions
What causes a bunion?
Factors that can cause or contribute to bunions include:
Wearing narrow footwear
Foot injury or trauma
Inflammatory arthritis
Neuromuscular conditions like cerebral palsy
Genetic disorders such as Down syndrome
Inherited traits
Flat feet or low arches
Is there treatment for a bunion?
Yes. Bunion pain can include elevating bare feet to relieve pressure and inflammation, applying an ice pack wrapped in a towel for 10 to 15 minute intervals, soaking feet in cool water to reduce swelling, and foot stretches.
Surgery can be done to correct the joint's misalignment, but it is usually only recommended if the bunion disrupts daily life.
How can I prevent bunions?
Not all bunions can be prevented, and they may form due to genetic factors. However, the following options may help reduce the likelihood of developing a bunion.
Wear comfortable shoes that fit correctly and have a wide toe box.
Avoid high heels.
Rest your feet when you can.
Are there exercises to treat bunion pain?
Yes, there are exercises that can relieve bunion pain and strengthen foot muscles. It is thought that weak muscles play a role in bunion pain and movement problems. A healthcare provider may prescribe specific exercises to improve foot muscle strength.
