Bunions (Hallux Valgus)

  • Medical Author:
    Philip A. Radovic, DPM, FACFAS

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View the Foot Problems Slideshow Pictures
Read about exercises that could treat and prevent bunions.

Bunion Treatment & Exercises

Bunions are more common in women, as you report, and are caused by a number of reasons, including shoes that are too tight, years of abnormal motion (like dancers on point), poor foot mechanics, bone deformities, flat feet, and arthritis.

Treatment usually includes shoes with a roomy toe box (you should be able to wiggle your toes; the toe box should be wide enough to accommodate the bony prominence), padding, over-the-counterarch supports, orthotics, and taping by a physical therapist or doctor. Surgery is an option when conservative treatment fails and you have chronic pain.

Picture of a bunion

Quick GuideFoot Health Pictures Slideshow: What Your Feet Say About Your Health

Foot Health Pictures Slideshow: What Your Feet Say About Your Health

Bunions facts

  • A bunion is a bony prominence from realignment of the joint at the base of the big toes.
  • Bunions most commonly affect the inner foot at the base of the big toe but also can affect the outside of the foot at the base of the little toe, referred to as a bunionette or tailor's bunion.
  • Bunions most commonly affect women.
  • Bunions may or may not cause symptoms.
  • Bunions are a progressive deformity.
  • Treatment of bunions can include rest, icing, alteration of footwear, foot supports (orthotics), medications, steroid injections, and/or surgery.

What are bunions?

The common bunion is a localized area of enlargement or prominence of the inner portion of the joint at the base of the big toe. The enlargement actually represents a misalignment of the big toe joint (metatarsal phalangeal joint) and, in some cases, additional bone formation. The misalignment causes the big toe to point outward and rotate (medically termed hallux abducto valgus deformity) toward the smaller toes. This deformity is progressive and will increase with time although the symptoms may or may not. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint, or MTP joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain. A more deep joint pain may occur as localized arthritis develops in later stages of the deformity.

A less common bunion is located at the joint at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor's bunion or bunionette.

What are the causes of bunions?

While the precise cause is not known, there seem to be inherited (genetic) factors that lead to abnormal foot function, such as overpronation that can predispose to the development of bunions. This is especially common when bunions occur in younger individuals. Abnormal biomechanics can lead to instability of the metatarsal phalangeal joint and muscle imbalance resulting in the deformity.

Although shoe gear doesn't directly cause a bunion, it can certainly make the bunion painful and swollen. Other less common causes of bunion deformities include trauma (sprains, fractures, and nerve injuries), neuromuscular disorders (polio or Charcot-Marie-Tooth disease), and limb-length discrepancies (one leg shorter than the other) where the longer leg develops the bunion. The longer limb will tend to cause the foot to overpronate.

Medically Reviewed by a Doctor on 2/24/2016

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