Definition

     A bunion is when your big toe points toward the second toe. This causes a bump on the edge of your foot, at the joint of your big toe.

Causes

• Foot injuries

• Deformities present at birth (congenital)

• Neuromuscular disorders, such as cerebral palsy or post-polio syndrome (post-poliomyelitis)

Signs and Symptoms

The signs and symptoms of a bunion include:

• A bulging bump on the outside of the base of your big toe

• Swelling, redness or soreness around your big toe joint

• Thickening of the skin at the base of your big toe

• Corns or calluses — these develop where the first and second toes overlap

• Persistent or intermittent pain

• Restricted movement of your big toe

Screening and Diagnostics

• Examination of the big toe

Treatment

     Treatment options vary depending on the severity of your bunion and the amount of pain it causes you. Early treatment is best to decrease your risk of developing joint deformities.

     Conservative treatment

     Nonsurgical treatments that may relieve the pain and pressure of a bunion include:

• Changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your toes.

• Padding and taping. Your doctor can help you tape and pad your foot in a normal position. This can reduce stress on the bunion and alleviate your pain.

• Medications. Acetaminophen (Tylenol, others) can control the pain of a bunion. Your doctor may suggest nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve), for relieving pain and reducing inflammation. Cortisone injections also can be helpful.

• Physical therapy. The heating effect of ultrasound therapy or whirlpool baths can provide relief from the pain and inflammation of a bunion.

• Shoe inserts. Padded shoe inserts (orthotics) can help control abnormal movement of your foot, reducing your symptoms and preventing your bunion from getting worse. Over-the-counter arch supports can provide relief for some people, though others may require prescription orthotics.

     Surgical options

     If conservative treatment doesn't provide relief, you may need surgery. A number of surgical procedures are performed for bunions, and no particular surgery is best for every problem. Knowing what caused your bunion is essential for choosing the best procedure to ensure correction without recurrence. Most surgical procedures include a bunionectomy, which involves:

• Removing the swollen tissue from around your big toe joint

• Straightening your big toe by removing part of the bone

• Permanently joining the bones of your affected joint

Prevention

     To help prevent bunions, wear comfortable shoes that fit well:

• Be sure your shoes don't cramp or irritate your toes.

• Choose shoes with a wide toe box — a half-inch of space between the tip of your longest toe and the end of the shoe.

• Your shoes should conform to the shape of your feet without causing undue pressure.

Complications

• Chronic foot pain

• Foot deformity

• Stiff foot

• Hallux varus (occurs with surgical over-correction, where the toe points away from the second toe)