Bunions are a foot problem not associated with the heel, but rather with the big toe area of the foot. It is actually a musculoskeletal foot condition affecting the big toe. The angle of the big toe has changed to point more inwards toward the second toe. In technical terms, the first and second metatarsal bones have separated slightly, which causes the big toe to change its position and angle slightly. In addition, a sometimes large and painful bump develops around the base of the big toe on the side of the foot. This painful condition can make walking and standing very painful. Many people adjust by wearing wider shoes to give the bunion additional space.

There are some varying theories about why bunions develop. They tend to be more prevalent in women, possibly because of extended use of high heeled shoes with cramped areas for the toes which force the toes inward. Eventually this may aggravate the big toe to the extent that it starts to angle inwards to accomodate the shoes. Other studies have stated that bunions are a product of heredity, having found that over 60% of people who suffer from bunions have a family history of the condition. Some types of feet have bones that tend to go out of alignment more easily than others. Heredity could certainly have an impact on this situation. It is advised for women to limit the use of high heels if there is any family history of bunions.

Painful bunion

Painful bunion on right foot

An enlargement of the bursa sac on the side of the foot near the big toe’s base is actually what makes up the painful bump on the side of the foot. The soft tissue in the area has become enlarged. This is usually because some of the small bones of the foot have undergone a structural deformation.

A bunion is usually plainly visible and is easily diagnosed, but a podiatrist will often perform an x-ray to determine the extent of the bunion. It is pretty common for other foot conditions to exist in conjunction with the bunion, which will show up in the x-ray. If the big toe angle towards the second toe is 15 degrees or more it is considered to be a bunion and is problematic.

Non-surgical treatment for bunions is similar to those associated with plantar fasciitis in many respects. Rest is recommended initially, along with orthotics, ice treatments, physical therapy, and medications. It is also imperative to change footwear to relieve pressure on the affected area. In addition, there are a variety of accesories available to help provide relief for bunion pain. These include splints, bunion sleeves, toe spreaders, and support socks. One or more of these options is usually quite effective in reducing the bunion size and pain to the point that normal activities can resume.

Bunion night splints

Bunion night splints


Surgery is usually not necessary, but in severe bunion cases it may be required.  The procedure may involve only repair to soft tissue. But a complete realignment of the bones around the big toe may be the only option. If surgery is deemed necessary, it is effective in about 90% of all cases. A 6 to 8 week recovery from surgery is considered typical.















Photos courtesy:

flickr/Kim Carpenter

flickr/Nina Jean