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Bunions

Key points

  • A bunion is a bony lump at the base of your big toe that can be painful.
  • You may be able to relieve your symptoms by taking painkillers.
  • If your bunion is very painful, you may need to have surgery.
  • Wearing the right shoes may be enough to prevent a bunion from forming.

Two pairs of feet

A bunion is a bony lump that develops at the base of your big toe. A bunion can be painful and affect how you walk. If your bunion is very painful and other treatments don't work, you may need surgery.

About bunions

A bunion is a bony lump on the side of your foot, which develops when your big toe starts to angle towards your second toe. The bunion will eventually cause you discomfort and pain. The skin over the lump can become red, blistered or infected. A fluid-filled space called a bursa may also develop under your skin in this area and this can be painful if it becomes inflamed. This is called bursitis. The deformity of your big toe combined with a bunion is sometimes referred to as hallux valgus by your GP.

Illustration showing a bunion in the right foot

Symptoms of bunions

If you have a bunion, you may have:

  • pain or stiffness of your big toe joint
  • swelling of your big toe joint
  • difficulty walking
  • difficulty finding shoes that fit

These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your GP.

Causes of bunions

You can get a bunion because of a problem with your big toe known as hallux valgus. ‘Hallux’ means the big toe and ‘valgus’ means that it’s pointing outwards towards your other toes. 

In hallux valgus, the bone in your foot at the base of your big toe, called the first metatarsal, moves out at the side of your foot. Your big toe then angles towards your other toes.

There are many factors that can contribute to bunions forming. Some of these include the following.

  • The most common cause of bunions is a problem with the way you walk. This is often caused by your foot rolling inwards as you walk. Over time, this problem can lead to a bunion forming.
  • Bunions can run in families, but just because your parents or grandparents have bunions, you won’t necessarily develop them too.
  • You’re much more likely to get bunions if you’re a woman. This may be because the ligaments in the foot (the structures that connect bones together) are usually looser in women than in men.
  • The type of shoes you wear may also affect whether or not you get a bunion. If you wear narrow or high-heeled shoes, this can put extra strain on the bones and muscles in your foot. This, in turn, can push your toes together (‘crowding’ the toes) and forces your big toe to point towards your other toes. Wearing poorly fitting shoes doesn’t cause bunions on its own, but it can worsen them.
  • Bunions are also sometimes associated with joint conditions such as osteoarthritis.
  • Other causes of bunions include gout, rheumatoid arthritis or an injury to your foot.

Diagnosis of bunions

Your GP will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your GP may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).

Treatment of bunions

Wearing the right shoes, using shoe inserts (orthoses) and padding, and taking painkillers can all help to ease your symptoms of a bunion. However, these treatments can’t cure a bunion or stop it getting worse. If you have severe pain or discomfort from a bunion, you may be advised to have an operation to correct it.

Self-help

One of the most important things you can do is to wear the right footwear. You should try to wear flat, wide-fitting shoes with laces or an adjustable strap that fits you properly. You may also want to place a bunion pad over your bunion to give it some protection from the pressure of your shoes. You can usually buy these pads from a pharmacy, or get them from your podiatrist or chiropodist. He or she may also recommend a shoe insert, which can be moulded specifically to your foot. Shoe inserts aim to reduce the pain of your bunion by improving how you walk.

Medicines

You can take over-the-counter painkillers, such as paracetamol or ibuprofen, to help relieve the pain and inflammation of your bunion. Always follow the instructions in the patient information leaflet that comes with your medicine. Medicines give temporary relief but they won’t be able to cure your bunion or prevent it from getting worse.

If you have a bunion as a result of underlying arthritis, your GP may prescribe specific medicines to treat this.

Surgery

If other treatments don’t help and your bunion is very painful, you may be referred to an orthopaedic or a podiatric surgeon for assessment. There are over 130 different operations that can be carried out to treat bunions. The simplest operations are called bunionectomies.

The majority of the operations aim to correct the alignment of your big toe. This will narrow your foot and straighten out your big toe joint as much as possible. An operation won’t return your foot back to normal, but most people find that surgery reduces their symptoms and improves the shape of their foot. The operation your surgeon will advise you to have will depend on how severe your bunion is and whether or not you have arthritis.

For more information on bunion surgery, see Related topics.

Prevention of bunions

You can reduce your risk of getting a bunion by wearing the right type of footwear. In particular, wearing tight, high-heeled shoes may make bunions worse. You can ask your GP or podiatrist for advice about your footwear. He or she will probably advise:

  • that your shoes are wide enough so there isn’t any pressure on the joints at the sides of your feet
  • choosing shoes with a low heel and a wide toe box where you can wiggle your toes comfortably
  • shoes with adjustable fastenings, such as laces, buckles or straps, that hold your feet comfortably inside your shoe
  • using soft insoles in your shoes as shock absorbers

 

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

 

Produced by Alice Rossiter, Bupa Health Information Team, May 2013.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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