Bunion (Hallux valgus)

Bunion (Hallux valgus)

Foot and Ankle ​Condition

Bunion (Hallux valgus)

A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often referred to as hallux valgus.

Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal structure of the bone changes, resulting in the bunion bump. This deformity will gradually increase and may make it painful to wear shoes or walk.

Anatomy

The big toe is made up of two joints. The largest of the two is the metatarsophalangeal joint (MTP), where the first long bone of the foot (metatarsal) meets the first bone of the toe (phalanx).

Bunions develop at the MTP joint.

Description

A bunion forms when the bones that make up the MTP joint move out of alignment: the long metatarsal bone shifts toward the inside of the foot, and the phalanx bones of the big toe angle toward the second toe. The MTP joint gets larger and protrudes from the inside of the forefoot.

The enlarged joint is often inflamed. The word “bunion” comes from the Greek word for turnip, and the bump on the inside of the foot typically looks red and swollen like a turnip.

Causes

Bunions may be caused by:

  • Wearing poorly fitting shoes—in particular, shoes with a narrow, pointed toe box that forces the toes into an unnatural position
  • Heredity—some people inherit feet that are more likely to develop bunions due to their shape and structure
  • Having an inflammatory condition, such as rheumatoid arthritis, or a neuromuscular condition, such as polio
Symptoms
  • Pain and tenderness
  • Redness and inflammation
  • Hardened skin on the bottom of the foot
  • A callus or corn on the bump
  • Stiffness and restricted motion in the big toe, which may lead to difficulty in walking
Treatment

In most cases, bunions are treated without surgery. Although nonsurgical treatment cannot actually “reverse” a bunion, it can help reduce pain and keep the bunion from worsening.

  • Changes in Footwear
  • Padding
  • Orthotics and Other Devices
  • Icing
  • Medications
Surgical treatment

Your doctor may recommend surgery for a bunion or bunionette if, after a period of time, you have pain and difficulty walking despite changes in footwear and other nonsurgical treatments. Bunion surgery realigns bone, ligaments, tendons, and nerves so that the big toe can be brought back to its correct position.

Surgery to remove an adolescent bunion is not recommended unless the bunion causes extreme pain that does not improve with a change in footwear or addition of orthotics. If an adolescent has bunion surgery, particularly before reaching skeletal maturity, there is a strong chance the bunion will return.