Bunions

Bunions are a common foot problem. If you have a bunion, you likely have pain and a deformed toe.

Bunions happen when extra bone and fluid grows at the base of the big toe. Common causes include high-intensity workouts, high heels, and genetics.

At UPMC, we have many ways to treat bunions, from non-surgical pain relief to surgery. Our diverse treatment options include lapiplasty, a new technique that targets bunions at their source.

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On this page

• What Are Bunions?
• What Are the Signs and Symptoms of Bunions?
• How Do You Diagnose Bunions?
• How Do You Treat Bunions?

What Are Bunions?

Doctors define bunions as a progressive bone disorder of the foot. Known as hallux valgus, they occur on the inside of the foot at the big toe joint.

Smaller bunions — called bunionettes — can form on the outside of the pinky toe.

A few of the factors that help bunions grow tend to occur slowly. They include:

• Certain types of arthritis.
• Genetic predisposition.
• Lifestyle.
• Natural aging process.

Bunion pain and symptoms vary. Some people have no complications, while severe cases may need surgery.

How common are bunions?

There are 3 million bunion cases in the U.S. each year.

People often seek ways to avoid bunions or, if they have them, find a pain-free stride.

What are the types of bunions?

There are 2 types of bunions:

• Genetic. Bunions you're born with often appear during the teen years.
• Acquired. These are bunions caused by lifestyle choices, such as the shoes you wear.

What causes bunions?

Bunions are caused by inflammation of the metatarsophalangeal joint, which connects the big toe to the foot. Over time, added pressure causes the big toe to shift behind the 2nd toe or 1st metatarsal bone.

Here's how a bunion forms:

• When there's inflammation, your big toe can turn toward the 2nd toe, making a painful bump on the inner edge of the toe. Sometimes, the big toe goes beneath the 2nd toe.
• If there's more pressure on the 2nd toe, it can cause that toe to shift out of its normal position. Sometimes, the 2nd toe will move toward the 3rd toe.
• As the problem gets worse, the foot might start to look different and unusual. Because of this change, wearing shoes might become hard.

Factors that can cause bunions to form include:

• Foot type.
• Foot injuries.
• Congenital deformities (defects you're born with).

What are bunion risk factors and complications?

More than half of U.S. women have bunions. Women are 9 times more likely than men to get this joint inflammation. Wearing shoes that are too small — a habit seen in 9 out of 10 women — may be a cause.

Bunion risk factors

Gender isn't the only risk factor for bunions. Others include:

• Family history. Your risk increases if you have a family member with bunions.
• Rheumatoid arthritis. This health issue affects joints in the body, including the big toe.
• Overpronation. This causes the foot to roll inward while walking due to low or weak arches.
• Foot injuries. These happen most often from lifestyle choices, such as intense workouts or the shoes you wear.
• Congenital deformities. Foot problems you're born with can make joints, nerves, and muscles weak, or cause limbs to be out of alignment.

Complications of bunions

Bunions can lead to long-lasting pain and may even cause arthritis as time goes on.

The constant stress on the joint in the middle of the foot and toe misalignment can make walking tough and painful.

How do I prevent bunions?

Dealing with bunions can be a challenge. But there are things you can do to help prevent them — or make daily activities more comfortable when they appear.

You can:

• Maintain a healthy weight. Being overweight isn't only linked to chronic diseases, but gaining weight can also cause your feet to spread. For instance, pregnant women often notice an increase in their shoe size due to the weight gain over 9 months.
• Choose comfortable shoes. Wear shoes with a wider toe box and avoid pointy toes or high heels. While tight shoes may not be the direct cause of bunions, they can make bunions worse.

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What Are the Signs and Symptoms of Bunions?

If you have a bunion, you'll have:

• Red, thick skin along the edge of the big toe.
• Tender skin.
• Bony bump at the bunion site.
• Joint pain.
• Altered toe position.
• Trouble walking.
• Issues wearing certain shoes.

When should I see a doctor about my bunion symptoms?

If you have a bunion, you can see your primary care doctor.

They may refer you to a podiatrist, a doctor who specializes in feet, or an orthopaedic surgeon.

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How Do You Diagnose Bunions?

To diagnose a bunion, your doctor will do a physical exam to check the bony bump where the bunion is. Seeing how the toe is out of place helps them figure out the right treatment.

They'll also ask about your:

• Health history. They'll want to know if you've injured your foot, have rheumatoid arthritis, or have a health issue you were born with.
• Family history. Tell the doctor if other family members have problems with bunions.

Your doctor will likely order an x-ray to better see how out of place your toe is. An x-ray can also show damage to other toes and bones in your foot and if there are other issues, like arthritis.

If your doctor thinks issues with blood flow or nerves might be causing your bunion, they'll order an ultrasound.

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How Do You Treat Bunions?

We can help some people find bunion relief without surgery. But you may need surgery if your bunion pain is severe.

Medicine to treat bunions

Many people find pain relief from bunions from over-the-counter pain relievers and anti-inflammatory drugs, like ibuprofen or naproxen.

Lifestyle changes for bunions

You can care for bunions and find pain relief without surgery by:

• Choosing wide-width shoes.
• Adding foam or felt padding in shoes to help separate toes.
• Wearing shoes with holes in the toe box when you're at home.

If nonsurgical changes to your footwear don't help with your bunions, your doctor may suggest surgery.

Surgery for bunions

UPMC offers a wide range surgical options to treat and remove bunions.

Our experts may suggest:

• Resection arthroplasty. Repairs the joint damage a bunion causes.
• Big toe tendon and ligament repair. Reinforces the structure of the joint or lengthens the toe. The focus is on tendons, ligaments, or other tissues around the joint.
• Arthrodesis. Removes the swollen joint surface and uses screws, wires, or plates.
• Osteotomy. Realigns the joint by using screws, plates, or pins to fix the bone deformity.
• Exostectomy. Removes the bump on the joint — often in conjunction with osteotomy.
• Lapiplasty. Corrects the source of the deformity, restoring the anatomy to its natural position without cutting the bone.

It's vital to know that surgery won't allow you to wear smaller shoes or keep wearing narrow-width footwear. Wearing tight shoes can lead to the return and worsening of bunions.

How long does it take to recover from bunion surgery?

After surgery, your doctor may suggest taking it easy for about a week. You may need a walker, cane, or crutches during this time.

Recovery from bunion surgery can take between 6 weeks and 6 months. It depends on how much of the soft tissue and bone the surgery involves.

You might have swelling in your feet for up to 6 months after bunion surgery. It may take up to a year to fully heal.

What happens after bunion treatment?

When our experts correct your bunion, whether through nonsurgical or surgical treatments, you should have:

• Relief from bunion pain.
• Improved toe alignment.

If you have bunion surgery, you'll have routine checkups with your UPMC orthopaedic surgeon so they can monitor your feet.

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