What Are Bunions?

If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion. More than one-third of women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes and high heels. Bunions may be hereditary, but many are from wearing tight shoes, and 9 out of 10 bunions occur in women. Too-tight shoes also can cause foot problems such as corns, calluses, and hammertoes.

If you have a painful swollen lump on the outside of your foot near the base of your little toe, it may be a bunionette​ ("tailor's bunion"). Similar to a bunion, bunionettes can be caused by wearing shoes that are too tight. 

Symptoms

With a bunion, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out. The skin may be red and tender, and wearing any type of shoe may be painful. This joint flexes with every step you take, so the bigger your bunion gets, the more it hurts to walk. Bursitis (painful swelling with inflammation) may set in. Your big toe may angle toward your second toe or move all the way under it. 

In addition, the skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe or the big toe. An advanced bunion may make your foot look deformed. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.

Prevention

Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, never force your foot into a tight shoe that crowds your toes or doesn't fit. Choose shoes that conform to the shape of your feet and ones with wide insteps, broad toe boxes, and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 1/4 inches.

If you already have a bunion, wear shoes that are roomy enough to not put pressure on the big toe. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You also may use protective pads to cushion the painful area.

Treatments

If your bunion has progressed to the point where you have difficulty walking or experience pain despite changing shoes, you may need surgery. Bunion surgery realigns bone, ligaments, tendons, and nerves so your big toe can be brought back to its correct position. Foot and ankle orthopaedic surgeons have several techniques to ease your pain. Many bunion surgeries are outpatient procedures, meaning the patient can go home the same day as surgery, using an ankle-block anesthesia. Recovery occurs over 3-6 months and may include persistent swelling and stiffness.

The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area.