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1. BUNIONS
E ven though bunions are a
common foot deformity, there
are misconceptions about them.
Symptoms, which occur at the site
of the bunion, may include:
• Pain or soreness
Many people may unnecessarily Bunion
• Inflammation and redness
suffer the pain of bunions for years • A burning sensation
before seeking treatment. • Perhaps some numbness
What Is a Bunion? Other conditions which may
Bunions are often described as a appear with bunions include calluses
bump on the side of the big toe. But on the big toe, sores between the
a bunion is more than that. The visi- toes, ingrown toenail, and restricted
ble bump actually reflects changes in motion of the toe.
the bony framework of the front part
of the foot. With a bunion, the big toe Diagnosis
leans toward the second toe, rather Bunions are readily apparent—you
than pointing straight ahead. This What Causes a Bunion? can see the prominence at the base
throws the bones out of alignment— Bunions are most often caused by an of the big toe or side of the foot.
producing the bunion’s “bump.” inherited faulty mechanical structure However, to fully evaluate your
Bunions are a progressive disorder. of the foot. It is not the bunion itself condition, the podiatric foot and ankle
They begin with a leaning of the that is inherited, but certain foot surgeon may take x-rays to determine
big toe, gradually changing the angle types that make a person prone to the degree of the deformity and assess
of the bones over the years and developing a bunion. the changes that have occurred.
slowly producing the characteristic Although wearing shoes that Because bunions are progressive,
bump, which continues to become crowd the toes won’t actually cause they don’t go away, and will usually
increasingly prominent. Usually the bunions in the first place, it sometimes get worse over time. But not all cases
symptoms of bunions appear at later makes the deformity get progressively are alike—some bunions progress
stages, although some people never worse. That means you may experi- more rapidly than others. Once
have symptoms. ence symptoms sooner. your podiatric surgeon has evaluated
your particular case, a treatment
Symptoms plan can be developed that is suited
Symptoms occur most often when to your needs.
wearing shoes that crowd the toes—
shoes with a tight toe box or high Treatment
heels. This may explain why women Sometimes observation of the bunion
are more likely to have symptoms is all that’s needed. A periodic office
Bunion than men. In addition, spending long evaluation and x-ray examination can
periods of time on your feet can determine if your bunion deformity
aggravate the symptoms of bunions. is advancing, thereby reducing your

2. chance of irreversible damage to the • Medications. Nonsteroidal anti- Recent advances in surgical
joint. In many other cases, however, inflammatory drugs (NSAIDs), techniques have led to a very high
some type of treatment is needed. such as ibuprofen, may help to success rate in treating bunions.
Early treatments are aimed at relieve pain. A variety of surgical procedures
easing the pain of bunions, but they • Icing. Applying an ice pack several are performed to treat bunions. The
won’t reverse the deformity itself. times a day helps reduce inflam- procedures are designed to remove
These options include: mation and pain. the “bump” of bone, correct the
• Changes in shoewear. Wearing • Injection therapy. Although rarely changes in the bony structure of the
the right kind of shoes is very used in bunion treatment, injec- foot, as well as correct soft tissue
important. Choose shoes that tions of corticosteroids may be use- changes that may also have occurred.
have a wide toe box and forgo ful in treating the inflamed bursa The goal of these corrections is the
those with pointed toes or (fluid-filled sac located in a joint) elimination of pain.
high heels which may aggravate sometimes seen with bunions. In selecting the procedure or
the condition. • Orthotic devices. In some cases, combination of procedures for your
• Padding. Pads placed over the area custom orthotic devices may be particular case, the podiatric surgeon
of the bunion can help minimize provided by the podiatric surgeon. will take into consideration the
pain. You can get bunion pads extent of your deformity based on
from your podiatric surgeon or When Is Surgery Needed? the x-ray findings, your age, your
purchase them at a drug store. When the pain of a bunion interferes activity level, and other factors. The
• Activity modifications. Avoid with daily activities, it’ time to discuss
s length of the recovery period will
activity that causes bunion pain, surgical options with your podiatric vary, depending on the procedure or
including standing for long periods surgeon. Together you can decide if procedures performed. ▲
of time. surgery is best for you.
This information has been prepared by the Consumer Education Committee of the American College of Foot and
Ankle Surgeons, a professional society of 5,700 podiatric foot and ankle surgeons. Members of the College are
Doctors of Podiatric Medicine who have received additional training through surgical residency programs.
The mission of the College is to promote superior care of foot and ankle surgical patients through education,
research and the promotion of the highest professional standards.
Copyright © 2004, American College of Foot and Ankle Surgeons • www.acfas.org