Bunion is the name for a prominent bump along the inside of your big toe. If you notice a swollen, painful big toe, you may have a bunion. More than one-third of women in America have bunions. Bunions often are hereditary, but they also develop from wearing tight shoes.
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.
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 may hurt to walk. Bursitis (painful swelling with inflammation) may set in. Your big toe may tilt 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.
Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, never force your foot into tight shoes that don't fit or that crowd your toes. 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 avoid putting 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, or a spacer to maintain the gap between the big toe and the second toe.
An X-ray of a foot with a bunion. The arrow points to the base of the big toe where the bunion sticks out from the foot.
If your bunion has progressed to the point where you have difficulty walking or experience pain despite changing shoes, you may be a candidate for surgery. Bunion surgery realigns bone, ligaments, tendons, and nerves so your big toe can be brought back to its correct position. There are several different techniques that can be performed to ease your pain; see a foot and ankle orthopaedic surgeon to discuss your options.
Most bunion surgeries are outpatient procedures, meaning you can go home the same day as surgery. Recovery occurs over 3-6 months and may include persistent swelling and stiffness.
Bunions usually develop due to a combination of inherited foot structure, abnormal biomechanics, and external factors such as tight or narrow footwear. Conditions like arthritis may also contribute to joint misalignment.
Yes, bunions are typically a progressive condition. Over time, the deformity can worsen, leading to increased pain, joint stiffness, and difficulty wearing shoes or walking.
A bunion is usually diagnosed during a physical exam. In some cases, X-rays are used to evaluate bone alignment and determine the severity of the deformity.
Non-surgical treatment focuses on relieving symptoms and slowing progression. This may include wearing properly fitting shoes, using orthotics or padding, modifying activities, and taking anti-inflammatory medications.
Surgery may be recommended when pain persists despite conservative treatment or when the deformity interferes with daily activities. The goal is to realign the joint, relieve pain, and restore function.
Recovery time varies depending on the procedure, but most patients require several weeks of limited activity and a few months for full recovery. Swelling and stiffness may continue during healing.
If left untreated, a bunion may worsen over time, causing increased pain, joint damage, and changes in foot structure. In more advanced cases, it can affect walking and lead to additional foot problems.
Contributors/Reviewers: David Porter, MD, PhD; Patrick Maloney, MD
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