Bunions are painful swellings that usually develop on the inner side of the foot near the base of the first toe (hallux). Bunions result from abnormal bone formation in the first metatarsalphalangeal joint and misalignment of the first toe.

Bunions can be related to inflammation or to degenerative disease (e.g., osteoarthritis). They cause redness, tenderness, and pain, and alter the normal position of the first toe. "Hallux abducto valgus" (HAV) is a term that refers to the hallux going away (abducting) from the midline of the body and twisting so the inside edge touches the ground and the outside edge turns upward. Essentially, this term describes the deviation of the toe toward the outside of the foot.

Bunions worsen over time and cause discomfort, difficulty walking, and skin problems such as corns and lesions. Sometimes, a small fluid-filled sac (bursa) near the joint becomes inflamed (called bursitis), causing additional swelling, redness, and pain.

Less frequently, bunions occur at the base of the fifth toe. When this occurs, it is called a "tailor's bunion."

Causes

Bunions are one of the most common foot problems. They often run in families, which suggests that the inherited shape of the foot may predispose people to them.

Pronated (flat) feet are unstable and often cause bunions. Body weight is repeatedly transferred to the hallux while walking, and in flat feet, this transfer of weight allows certain muscles to become stronger than others. This overpowering of muscles causes the toe to bend and deform.

Bunions may be caused by tight, pointy-toed, or high-heeled shoes, and shoes that are too small. Women get bunions much more often than men. Improper shoes exacerbate the underlying cause of flat, unstable feet.

Treatment

Fungicidal and fungistatic chemicals, used for athlete's foot treatment, frequently fail to contact the fungi in the horny layers of the skin. Topical or oral antifungal drugs are prescribed with growing frequency.

In mild cases of the infection it is important to keep the feet dry by dusting foot powder in shoes and hose. The feet should be bathed frequently and all areas around the toes dried thoroughly.

Come in For a Consultation

Treatment for bunions includes a thorough evaluation by a podiatrist. The only way to eliminate bunions is by surgical removal. Treatment usually involves applying ice to the feet for approximately 15 minutes, 3 or 4 times a day to reduce pain and swelling.