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A bunion is a bony lump that develops at the main joint between the big toe and the foot. It forms when your big toe pushes inwards towards the smaller toes, pulling the joint out of line.

Bunions may cause you problems; alternatively, they may be harmless.

What is a bunion? 

Bunions usually develop slowly, and many people have them for years with no problems at all. However, some people find:

  • the bunion can push their toes and feet out of shape
  • the skin covering the bunion can get red and inflamed or callused
  • the bunion can make wearing shoes and walking difficult and painful

Some people get a smaller bunion, known as a bunionette, in the joint of the smallest toe. 

Causes of bunions 

Bunions can run in the family, in which case they are caused mainly by an inherited weak or faulty structure of the foot.

They can also be caused by:

Wearing shoes that are too narrow and tight can cause bunions in feet that are already prone to this condition. Experts disagree on whether tight shoes alone can cause bunions, but they definitely make them worse.

Avoid high-heeled shoes with pointy tips that squeeze the toes together. The heels tip your body weight forward, putting greater pressure on the toes which are rammed into the end of the shoe.

Diagnosis of bunions

Your doctor will talk to you and do a physical examination to see how severe your bunions are. They might also say you need to have an X-ray of your foot.

The doctor might also order blood or other laboratory tests if they suspect an underlying disease is the cause. If necessary, they’ll refer you to an orthopaedic surgeon or other specialist.

Treatment for bunions

The first thing to do is to wear comfortable, softer, wider shoes that allow your toes enough space to spread out. Walk barefoot when possible. Often this eases the discomfort and stops the bunion developing further.

Other ways to reduce the pain and pressure of bunions include:

  • using special cushioning bunion pads
  • strapping or taping your toe or foot
  • wearing orthotics (shoe inserts) or orthopaedic shoes
  • taking anti-inflammatory medicines such as ibuprofen to relieve the pain and inflammation
  • having a cortisone injection
  • applying an ice pack or hot beanbag to the bunion.

If these things don’t work and your foot is deformed or very painful, your doctor might refer you to an orthopaedic surgeon. Before agreeing to surgery, ask what is involved and the benefits and risks to you. It can take a long time to recover from bunion surgery.

Prevention of bunions

Take care of your children’s feet and your own feet. Always select comfortable, wide shoes that fit properly and don’t squeeze your toes together.

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Last reviewed: February 2018

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