n Foot and Ankle - Bunions - AOA Orthopedic Specialists


If the joint that connects the big toe to the foot has a swollen, sore bump, a patient may have a bunion.

With a bunion, the base of the big toe (metatarsophalangeal joint) gets larger and sticks out. The skin over it may appear red and feel tender. Wearing any type of shoe may cause pain. The metatarsophalangeal joint flexes with every step taken. The larger the bunion gets, the more it hurts to walk. If left untreated, bursitis may also set in. The big toe may angle toward the second toe, or even move all the way under it overlapping. Pressure from the big toe may force the second toe out of alignment, sometimes overlapping the third toe. The skin on the bottom of the foot may grow thicker and feel painful. An advanced bunion may make the foot look grotesque. If the bunion progresses, patients may have difficulty while walking. The pain from a bunion may feel chronic and the patient may develop arthritis. If bunions go left untreated, they can lead to the need of a midfoot fusion.


More than half the women in America have bunions, and the cause of bunions often occurs from wearing tight shoes, narrow shoes, and high heels. Nine out of ten bunion cases happen to women. Bunions may also occur due to genetics.

Too-tight shoes can also cause other disabling foot problems including corns, calluses, and hammertoes.


The symptoms of bunions include:

  • The base of the big toe getting larger and sticking out, with the covering skin appearing red and tender
  • Pain with wearing shoes
  • Pain with walking
  • The big toe pushing the second toe out of alignment


Doctors start treatment using conservative methods. Conservative treatments typically work without the need for surgery. Prevention remains the best method when it comes to bunions. To minimize the chances of developing a bunion, never force the foot into a shoe that does not fit. Choose shoes that conform to the shape of the feet. Patients should seek shoes with wide insteps, broad toes, and soft soles. Avoid short, tight, or sharply pointed shoes and those with heels higher than 2 1/4 inches. If an individual already has a bunion, the should wear roomy shoes that have enough space to not put pressure on the bunion. Removing the pressure places on the bunion often alleviates painful symptoms. Individuals suffering from bunions can have shoes professionally stretched. Patients may also utilize protective pads to reduce pressure placed on the bunion.

If the bunion has progressed to the point to difficulty with walking or experience pain despite accommodating shoes, the treating physician may recommend surgery. Bunion surgery realigns bone, ligaments, tendons, and nerves in order to allow the big toe to go back to the correct position. Orthopedic surgeons have several techniques to ease the pain, for instance Lapidus Arthrodesis. Many bunion surgeries allow the patient to return home from the hospital on the same day of surgery using an ankle-block and anesthesia. Recovering from a bunion may include persistent swelling and stiffness.


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