Bunions
Medical Author: William C. Shiel Jr., MD, FACP, FACR
All of the women in my family have horrible bunions. Are there any exercises that can ward off or help bunions?
Author: Richard Weil, MEd, CDE
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
 A bunion is an irregular bony prominence (a bump) on the joint where your
big toe meets the main bones of your foot. The bunion causes the end of the
big toe to bend toward the other toes and crowd them, while the bone at the
base of the toe where it meets the foot moves outward beyond the normal
limits of where the bone should be. Pain is caused by inflammation and the
bone pressing against the shoe. 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-counter arch supports, orthotics, and
taping by a physical therapist or doctor. Surgery is an option when
conservative treatment fails and you have chronic pain.
What are bunions?
The common bunion is a localized area of
enlargement of the inner portion of the joint at the base
of the
big toe. The enlargement actually represents additional bone
formation, often in combination with a misalignment of the
big
toe. The normal position of the big toe (straight forward)
becomes outward-directed toward the smaller toes. The
enlarged
joint at the base of the big toe (the first
metatarsophalangeal
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 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.
Who develops bunions?
Bunions most commonly affect women. Some
studies report that bunions occur nearly 10 times more
frequently in women then men. It has been suggested that
tight-fitting shoes, especially high-heel and narrow-toed,
might
increase the risk for bunion formation. Bunions are
reported to
be more prevalent in people who wear shoes than in barefoot
people. There also seem to be inherited (genetic) factors
that
predispose to the development of bunions, especially when
they
occur in younger individuals.
Other risk factors for the development of
bunions include congenital (present from birth) abnormal
formation of the bones of the foot, nerve conditions that
affect
the foot, rheumatoid arthritis, and injury to the foot.
Bunions
are common in ballet dancers.
What are symptoms of a bunion?
Bunions may or may not cause symptoms. A
frequent symptom is pain in the involved area when walking
or
wearing shoes that is relieved by resting. A bunion causes
enlargement of the base of the big toe and is usually
associated
with positioning of the big toe toward the smaller toes.
This
leads to intermittent or chronic pain at the base of the
big toe.
Bunions that cause marked pain are often
associated with swelling of the soft tissues, redness, and
local
tenderness.
Next: How is a bunion diagnosed? »
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