Many people think of a bunion as a cosmetic problem because it changes the appearance of the foot. But it’s more than cosmetic. Bunion pain is common and bunions can also cause inflammation and other problems that may require medical treatment.
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What is a bunion?
A bunion is a bony bump at the base of the big toe (also known as hallux valgus). Bunions are caused by years of pressure on the big toe joint. The pressure compresses the big toe and pushes it toward the second toe. The bump can be covered by hardened skin or a callus.
As a bunion gets worse, the joint at the base of your big toe gets larger and starts to stick out. Your big toe may be pushed under or over the other toes. The joint can become sore and inflamed and walking can become painful and difficult.
Expert bunion evaluation
Our orthopedic surgeons and podiatrists are specially trained in treating foot problems. We’ll first try nonsurgical methods – like better footwear and physical therapy – to make your foot feel better.
If you need surgical treatment for a bunion, our experts will explain your options to you. These procedures may include realigning the toe joint or surgically repairing tendons and ligaments.
Since we’re one of Wisconsin’s largest regional health care systems, we have convenient locations all over eastern Wisconsin. So it’s easy to find a doctor near you.
What causes bunion pain?
The tendency to develop bunions can be inherited. However, the biggest factor in how bunions grow tends to be shoes that squeeze your toes unnaturally. That’s why women experience bunions more often than men do.
Bunions may result from:
- Tight or poorly fitting shoes: Especially narrow, pointed shoes that force the toes together or high heels that put more stress on the toes.
- Heredity: Foot shape or biomechanics (foot movement patterns).
- Inflammatory disease: Health conditions like rheumatoid arthritis.
Signs & symptoms of bunions
The clearest sign of a bunion is a bump on the inside of the foot at the base of the big toe.
You might notice other bunion symptoms like:
- A callus (toughened skin) where the bunion rubs on your shoes
- Thick skin on the bottom of your big toe
- The tip of your big toe turning toward the second toe
- Toes that overlap, which happens when bunions are severe
- Calluses on your second toe
- Persistent or occasional pain in the joint or in the toes
- Stiffness in the toes – especially the big toe – that makes walking painful or difficult
Health issues related to bunions
Bunions can cause related problems including:
- Bursitis: Bursitis is inflammation of the bursa (a fluid-filled sac that cushions the bones of the joint). When a bunion forms, the bursa becomes irritated and painful.
- Arthritis: Bunions can cause the bones of the foot to rub at uncomfortable angles. This rubbing can wear away the cartilage, the smooth tissue that cushions the ends of bones. The result can be arthritis, a painful condition that can cause the bone to break down.
- Hammer toe: Bunions can cause the toe next to your big toe to bend abnormally and form a hammer toe, creating more pressure and pain.
Types of bunions
Most bunions form at the base of the big toe, but there are other types of bunions.
- Bunionette: A bunionette is a bunion that grows in the joint below the little toe, on the outside of the foot. A bunionette is a bunion’s smaller cousin because the joint is smaller.
- Adolescent bunion: Sometimes a bunion forms in a young person’s foot – usually in girls between the ages of 10 and 15. These bunions are usually genetic (inherited) rather than caused by shoes.
Diagnosis and treatment for bunions
Diagnosis of a bunion can happen just from a physical examination. But your doctor will likely order some tests to learn more about how the bones and soft structures of your foot are being affected by the bunion so they can come to a complete orthopedic diagnosis.
These tests may include:
- X-rays: X-rays let your doctor see inside your bunion. The X-ray provides information about how the toes are aligned. You’ll have an X-ray while you’re standing, so we can see how your foot’s shape changes when you put weight on it.
- CT scan or other imaging: A CT scan combines pictures of bone and soft tissue from multiple angles, giving your doctor a more complete view of your bunion.
- Blood tests: To learn whether another condition has contributed to the bunion, we may order blood tests.
Nonsurgical treatment for bunions
Nonsurgical methods are often enough to treat many bunions, especially if you catch them early.
All the members of your care team will communicate closely with each other to provide you with the best care possible. Your doctor and your physical therapist will work together to find personalized treatments that work for you.
Some of the nonsurgical options are:
- Wearing well-fitting footwear: Choose shoes that have a wide toe box that is large enough to hold your toes without pressuring them. Choose shoes with low heels and padding, like athletic shoes.
- Padding: Cushion any irritated skin with moleskin or gel bunion pads, available at your local pharmacy.
- Taping and splinting: We can show you how to tape your toes to help keep them in a normal position. Some people also find pain relief from wearing a splint at night.
- Pain medication: Over-the-counter anti-inflammatory medications can reduce pain and inflammation. If you have arthritis, your doctor may prescribe medication for it. Find out more about the kinds of orthopedic pain we treat.
- Custom foot orthotics: Orthotic shoe inserts support your foot and control its position. They can provide pain relief and keep the condition from getting worse.
- Physical therapy: Physical therapy treatments like ultrasound therapy, whirlpool, massage, heat therapy and icing can provide relief from bunion pain.
- Injections: We can inject medications to minimize pain and inflammation and make it easier to move your joint.
Nonsurgical treatments won’t fix a bunion. However, they’ll treat the pain and keep it from getting worse.
Bunion surgery
If you’ve tried nonsurgical treatments without success, you might be ready to talk to your doctor about surgery. Surgery can help when a bunion interferes with wearing regular shoes and keeps you from fully enjoying your life.
Your doctor will talk with you about your specific foot shape and your surgical options. We may perform surgery to:
- Realign the toe joint
- Repair tendons and ligaments
- Remove part of the bump or joint
Most people go home the same day they have bunion surgery. It usually takes about four to eight weeks before you can return to all your regular activities.
Bunion surgery may not eliminate the bunion entirely, but it does provide pain relief for most people. After surgery, it's important to continue wearing well-fitting shoes to avoid the return of the bunion.
