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Bunions

A bunion is a bony bump that forms on the joint at the base of your big toe. A bunion forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. The skin over the bunion might be red and sore.

Wearing tight, narrow shoes might cause bunions or might make them worse. Bunions can also develop as a result of an inherited structural defect, stress on your foot or a medical condition, such as arthritis.

Smaller bunions (bunionettes) also can develop on the joint of your little toes.

Symptoms Causes Risk factors Complications Prevention

The signs and symptoms of a bunion include:

  • A bulging bump on the outside of the base of your big toe
  • Swelling, redness or soreness around your big toe joint
  • Thickening of the skin at the base of your big toe
  • Corns or calluses — these often develop where the first and second toes overlap
  • Persistent or intermittent pain
  • Restricted movement of your big toe

When to see a doctor

Although bunions often require no medical treatment, see your doctor or a doctor who specializes in treating foot disorders (podiatrist or orthopedic foot specialist) if you have:

  • Persistent big toe or foot pain
  • A visible bump on your big toe joint
  • Decreased movement of your big toe or foot
  • Difficulty finding shoes that fit properly because of a bunion

Bunions develop when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance in pressure makes your big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of your foot.

Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to bunion development. Other causes include:

  • Inherited foot type
  • Foot injuries
  • Deformities present at birth (congenital)

Bunions may be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause.

These factors may increase your risk of bunions:

  • High heels. Wearing high heels forces your toes into the front of your shoes, often crowding your toes.
  • Ill-fitting shoes. People who wear shoes that are too tight, too narrow or too pointed are more susceptible to bunions.
  • Arthritis. Pain from arthritis may change the way you walk, making you more susceptible to bunions.
  • Heredity. The tendency to develop bunions may be present because of an inherited structural foot defect.

Although they don't always cause problems, bunions are permanent unless surgically corrected. Possible complications include:

  • Bursitis. This painful condition occurs when the small fluid-filled pads (bursae) that cushion bones, tendons and muscles near your joints become inflamed.
  • Hammertoe. An abnormal bend that occurs in the middle joint of a toe, usually the toe next to your big toe, can cause pain and pressure.
  • Metatarsalgia. This condition causes pain and inflammation in the ball of your foot.

To help prevent bunions:

  • Be sure your shoes don't cramp or irritate your toes.
  • Choose shoes with a wide toe box — there should be space between the tip of your longest toe and the end of the shoe.
  • Your shoes should conform to the shape of your feet without squeezing or pressing any part of your foot.
  • Avoid pointy-toed shoes.
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