What is bunions?

A bunion is an enlargement of bone or tissue around the joint at the base of the big toe. The big toe may turn toward the second toe. The tissues around the joint may be swollen and tender.

A bony bump at the base of the little toe is called a bunionette or tailor's bunion. The little toe also bends inward, and the joint swells or enlarges.

Your bunion may not cause any symptoms. If you do have symptoms, they may include:

• Pain in your big toe.
• Red or irritated skin over the bunion.
• Swelling or enlargement of the metatarsophalangeal joint at the base of the big toe.
• Displacement of the big toe, so that it points toward the other toes and causes problems in other toes, such as hammer toe.
• Joint pain or stiffness.

A bunionette can cause similar symptoms at the base of the little toe.

Bunions and their symptoms develop slowly over time.

Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be:

• When did the bunions start?
• What activities or shoes make your bunions worse?
• Do any other joints hurt?

The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight.

X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout, rheumatoid arthritis, or joint infection.

Bunions are treated to ease pain and help with walking and other daily activities. Most bunions can be treated at home.

Home treatment includes wearing shoes that have wide and deep toe boxes (the area that surrounds the toes). The shoes should have low or flat heels and good arch supports. You can wear pads or splints to cushion the bunion and take pressure off the toe.

Applying ice and taking over-the-counter medicine can help relieve toe pain.

Avoid activities that put pressure on your big toe and foot. Try activities that don't put a lot of pressure on your foot, such as swimming or biking.

If you have a bunion but don't have pain or discomfort, treatment may not be needed.

Surgery is an option only if other treatments don't help. Bunion surgery is done to help restore normal alignment to the toe joint.

• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
• Wear shoes that have a wide and deep space for the toes. Also, wear shoes that have low or flat heels and good arch supports. Do not wear tight, narrow, or high-heeled shoes.
• Try bunion pads, arch supports, toe spacers, or shoe inserts. They can help shift your weight when you walk to take pressure off your big toe.
• Put moleskin or another type of cushion on or around the bunion to keep it from rubbing against your shoe.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time as needed. Put a thin cloth between the ice and your skin.
• Prop up your foot on a pillow when you ice your toe or anytime you sit or lie down. Try to keep it above the level of your heart. This will help reduce swelling.