Bunion

Definition

A bunion is a thickened lump at the base of the big toe. It is the result of the movement of the base of the big toe away from the smaller toes. At the same time, the end of the big toe moves toward the smaller toes. This instability creates metatarsophalangeal (MTP) joint inflammation and bursitis at the base of the big toe.

Bunion

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Causes

The exact cause of bunions is unknown, but it is likely a combination of genetics and environmental factors.

Risk Factors

Bunions are more common in women than in men. Other factors that may increase your chance of getting a bunion include:

• Structural deformities in the foot, which may be related to genetics
• Family history of foot disorders
• Certain conditions, such as cerebral palsy , multiple sclerosis , or Marfan syndrome
• Flat feet , which transfers too much weight to the MTP joint
• Activities that put undue stress on the foot, such as ballet
• High-heel shoes
• Poorly fitting, narrow shoes
• Diabetes

Symptoms

Bunions may cause:

• Tip of the big toe that turns in toward the other toes and may overlap the second or third toe
• Firm bump on the inside edge of the foot at the base of the big toe
• Restricted or painful motion of the big toe
• Foot pain and stiffness
• Fluid-filled cyst between the skin and the bony lump

You should seek medical attention if you have diabetes and you are having problems with your feet.

Diagnosis

You will be asked about your symptoms and medical history. A foot exam will be done. An x-ray of your foot will be used to diagnose the bunion. It will also show the severity and amount of damage.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Supportive Care

It is important to relieve pressure on the bunion to stop progression of the deformity. This may include:

• Padding the bunion to reduce pain
• Taping the area to reduce stress and pain
• Shoes that are wide and deep in the toe area to relieve pressure on the bunion
• Shoe inserts to reduce symptoms and prevent worsening of the deformity

Prescription or over-the-counter medications and/or cortisone injections may be advised to reduce pain.

Physical Therapy

A physical therapist will assess the bunion. Ultrasound may be done to help relieve inflammation and pain.

Surgery

Surgery may be needed to relieve the pressure and repair the toe joint, if the other treatments fail. Surgical procedures include:

• Removal of the bony lump
• A more involved procedure to cut the bone and realign the joint

Prevention

To help reduce your chance of getting a bunion, take these steps:

• Wear wide toed shoes and comfortable footwear that do not pinch the toes.
• Prevent a minor bunion from worsening with bunion pads and proper shoes.