• Bunion

    (Hallux Valgus)


    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 top 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.
    Copyright © Nucleus Medical Media, Inc.


    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 shows
    • Diabetes


    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 outside edge of the foot or 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.


    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.


    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 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


    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.


    American Podiatric Medical Association http://www.apma.org

    OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.org


    Ontario Podiatric Medical Association http://www.opma.ca

    Health Canada http://www.hc-sc.gc.ca


    Bunions. American Academy of Orthopaedic Surgery Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00155. Updated September 2012. Accessed March 2, 2015.

    Bunion surgery. American Academy of Orthopaedic Surgery Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00140. Updated September 2012. Accessed March 2, 2015.

    Ferrari J, Higgins JP, et al. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database of Syst Rev. 2004;CD000964.

    Foot care. National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/foot-care. Updated January 22, 2015. Accessed March 2, 2015.

    Hallux valgus and bunion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 18, 2014. Accessed March 2, 2015.

    Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull. 2011;97:149-167.

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