What is a bunion?

Bunions are a common foot condition in which a bony lump develops at the main joint between the big toe and the foot. The bunion forms when the big toe angles outwards towards the smaller toes, pulling the joint out of line.

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. 

What are the 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:

• conditions causing abnormal deformities such as rheumatoid arthritis or cerebral palsy
• conditions that damage nerves in the feet such as diabetes
• injuries to the foot

Wearing shoes that are too narrow and tight can be a risk factor for 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.

How are bunions diagnosed?

If you think you have bunions, your doctor will talk to you and do a physical examination to see how severe your bunions are. They might order 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.

How are bunions treated?

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.
• maintain a healthy weight to reduce pressure on joints in the feet

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.

How can bunions be prevented?

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.