Your Complete Guide to Bunions, Including How to Prevent and Treat Them
Learning to manage painful bunions could keep you off the operating table. Here's a complete guide to bunion causes, symptoms, treatment, and prevention.
Bunions are common
After a long day on your feet—or even just a few hours wearing dress shoes—you might experience aching foot and toe pain.
Specifically, you might have bunion pain. Bunions are deformities of the big toe that can be very painful.
Bunions are very common. About one in three adults in the United States has a bunion, according to the United States National Library of Medicine. Your chances of developing a bunion increases as you get older.
Bunions are more frequent in women than men, likely because of foot structure, genetic issues, and often footwear choices.
What is a bunion? What causes one? And how can you prevent and treat them? Read on to find out.
What is a bunion?
Bunions look like bony bumps at the side of the base of the big toe joint. But they aren’t exactly bumps.
What you see is what happens when the big toe leans toward the second toe: the joint juts out. The medical name for a bunion is hallux valgus. The phrase is Latin: “Hallux” means big toe, and “valgus” means misalignment.
Bunions start out small and grow slowly, usually getting worse over time. With severe bunions, the big toe may eventually angle over or under the second toe.
(Learn more about these common foot problems and podiatrists’ solutions for them.)
Types of bunions
In addition to the common bunion, which is found on the base of the big toe joint, there are several other types.
Bunionette: This typically affects the baby toe. It is also known as a “tailor’s bunion” because tailors would sit cross-legged all day with the sides of their feet rubbing on the floor. A bunionette typically has the same symptoms as a bunion, with pain and a callus over the bump. Bunionettes are just one of the conditions that can cause pain on the outer side of the foot.
Adolescent bunions: These are most common in young people between the ages of 10 and 15. They may start around this age because it’s about the time kids begin wearing more stylish shoes. People who have them can usually move their big toe, but it often hurts. They typically run in families and are more common in girls, though boys can get them, too.
What causes bunions?
Doctors aren’t totally sure what causes bunions, but they think several factors can play a part.
Genetics seems to play the biggest role. If either of your parents had bunions, there’s a good chance that you will too.
For a study in Arthritis Care & Research, scientists analyzed six years of data on 1,370 adults whose feet had been examined for deformities. They used software to look at the heritability of foot disorders. Of the participants, 31 percent had bunions. The study found bunions were “highly inheritable” in people of European descent depending on age and gender.
Inherited factors like weak connective tissue, a short Achilles tendon, short calf muscles, or a joint disease such as rheumatoid arthritis, can also increase your chances, according to a report from the National Center for Biotechnology Information.
It was long believed that tight or poor-fitting shoes—like those that have narrow, pointed toes—could cause bunions. Instead, doctors believe that shoes may make bunions grow earlier or get worse faster.
(Learn these about the shoe mistakes that hurt your feet.)
Bunion signs and symptoms
The most obvious sign of a bunion is the bump-like deformity on the side of the base of the big toe.
Bunions aren’t always painful, but they can cause a deep ache or a pain that hurts more when you touch or put pressure on it.
Other possible symptoms, according to the American Academy of Orthopaedic Surgeons, include:
- Redness and inflammation
- Hardened skin on the bottom of the foot
- Callus or corn on the bunion
- Stiffness in the big toe, which can cause difficulty walking
Jatuporn Tansirimas/Getty Images
How to prevent bunions and treat them
You may not need to treat a bunion unless it is causing problems.
But if you experience bunion pain, have trouble walking, or experience any other issues, start with home treatment. In most cases, you won’t need surgery.
The lifestyle tips below can help prevent bunions, treat bunion pain, and keep bunions from getting worse.
One of the first steps to preventing bunions and treating bunion-related pain is to make sure you have comfortable, properly fitted shoes. Avoid pointed, narrow shoes that squeeze your toes together. Instead, buy shoes that conform to the shape of your foot and have a roomy toe box.
(Here are more tips for bunion pain relief from podiatrists.)
Your doctor may suggest you wear orthotics to take the pressure off your bunion. These are special insoles designed to give support and to address individual foot issues, such as flat feet or high arches.
There are expensive, custom versions designed just for your feet or more affordable drugstore varieties. Talk with your podiatrist to determine which option is best for your foot problems, pain, and budget.
Toe spacers can be placed between your toes to separate them and hold them in their normal position. They may give some relief for bunion pain, according to a 2018 study published in the Journal of the American Podiatric Medical Association.
Researchers randomly assigned 56 women with moderate bunions to one of two groups. The first did specific foot stretches and exercises and wore toe separators for more than eight hours each day. The second group didn’t receive any treatment. After three months, those who did the exercises and wore the devices reported less pain and more flexibility and strength than those in the control group. (Here are some bunion exercises that can help you find relief too.)
Of course, this was a small study, and it doesn’t prove the toe spacers caused the pain relief. After all, it’s possible the stretches and exercises made the biggest difference. More research is needed before experts can say for sure whether toe spacers really help with bunion pain.
In addition to toe spacers, a specially designed splint can be worn at night. It holds your toe in a straight position to try to ease pain. Check out these recommended bunion correctors and learn more about how they work.
A piece of foam or gel padding can help cushion your bunion and ease some of the pain throughout the day. You can fashion a DIY bunion pad or look for over-the-counter bunion cushions at pharmacies and online.
Just make sure the pad isn’t too big or too thick or it can make the pain worse.
Apply an ice pack to your bunion a few times a day for about 20 minutes each time to help ease swelling and pain. Don’t apply ice directly on skin, though. Instead, wrap it in a cloth. (Find out more: Should you use ice or heat for pain? )
Take nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen and naproxen to help relieve pain and reduce swelling.
In some cases, your doctor may suggest prescription medicine, especially if your bunion is caused by arthritis.
Your doctor might suggest surgery for bunion removal if you try these lifestyle treatments and still have pain and trouble walking. Surgery helps realign the toe, moving it back to its correct position.
There are different types of surgery depending on the severity of your bunion. It typically involves an osteotomy, which is cutting and removing a piece of bone. From there, ligaments, tendons, and nerves have to be put into the proper place.
For most procedures, some of the bone is shaved off the enlarged side of the joint. For more severe bunions, some of the top of the joint is also removed or part of the middle of the joint is cut away. The bone is then repositioned in order to shift the toe back into place.
Sometimes screws, plates, or pins are used to keep the toe in place. Recovery can be painful and can take several months. Results aren’t guaranteed.
Next, check out the things your podiatrist wishes you knew.
- American Academy of Orthopaedic Surgeons: “Bunions”
- Harvard Health: “What to do about bunions”
- U.S. National Library of Medicine: “Bunion”
- National Center for Biotechnology Information: “Bunions: Overview”
- Arthritis Care & Research: “High Heritability of Hallux Valgus and Lesser Toe Deformities in Adult Men and Women”
- Journal of the American Podiatric Medical Association: "Foot Mobilization and Exercise Program Combined With Toe Separator Improves Outcomes in Women with Moderate Hallux Valgus at 1-Year Follow-up: A Randomized Clinical Trial"
- Harvard Health: "Bunions and bunionettes"
- Podiatry Institute: "Juvenile and Adolescent Hallux Valgus"