Overview
When the big toe is misaligned, it creates an unnatural bump on the inside of the forefoot (see image below). In addition to being unsightly, the lump or bunion can cause pain and make buying shoes difficult. Some people are born predisposed to bunions. But most people acquire them over time from ill-fitting footwear that squeezes the big toe inward toward the other toes. About four out of five bunion pain patients are female, a near perfect fit for the bad shoe theory. The good news, Bunions can be corrected, often with better-fitting shoes and custom orthotics. There are also some cases that cause severe bunion pain and do not respond to conservative treatment. For those patients, bunion surgery called bunionectomy may be necessary.
Causes
People born with abnormal bones (congenital) in their feet. Inherited foot type. Foot injuries. Inflammatory or degenerative arthritis causing the protective cartilage that covers your big toe joint to deteriorate. Wearing high heels forces your toes into the front of your shoes, often crowding your toes. Wearing shoes that are too tight, too narrow or too pointed are more susceptible to bunions. Pain from arthritis may change the way you walk, making you more susceptible to bunions. Occupation that puts extra stress on your feet or job that requires you to wear ill-fitting shoes. The tendency to develop bunions may be present because of an inherited structural foot defect.
Symptoms
Movement of the big toe towards the smaller toes. Bulging bump on the outside of the base of the big toe. Restricted movement of the big toe. Swelling, inflammation, redness or soreness around your big toe joint. Persistent or sporadic dull, sharp or aching pain in or around the big toe. Corns, blisters and calluses which can develop when the first and second toes overlap. Over time, more severe symptoms can occur such as arthritis of the big toe, stress fractures and problems walking.
Diagnosis
Generally, observation is adequate to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your physician may order X-rays that will show the extent of the deformity of the foot.
Non Surgical Treatment
The non-invasive treatments for bunions are many and include changes in footwear, icing the sore area, over the counter pain medications, orthotic shoe inserts, and weight management. If these conservative measures fail to arrest your pain and discomfort, your foot and ankle surgeon may recommend a bunionectomy or similar surgical procedure, depending on your condition.
Surgical Treatment
If nonsurgical treatment fails, you may want to consider surgery. Many studies have found that 85 to 90 percent of patients who undergo bunion surgery are satisfied with the results. Reasons that you may benefit from bunion surgery commonly include severe foot pain that limits your everyday activities, including walking and wearing reasonable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain. Chronic big toe inflammation and swelling that doesn't improve with rest or medications. Toe deformity-a drifting in of your big toe toward the small toes. Toe stiffness-inability to bend and straighten your toe. Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person. Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medication. As you explore bunion surgery, be aware that so-called "simple" or "minimal" surgical procedures are often inadequate "quick fixes" that can do more harm than good. And beware of unrealistic claims that surgery can give you a "perfect" foot. The goal of surgery is to relieve as much pain, and correct as much deformity as is realistically possible. It is not meant to be cosmetic.

Causes
People born with abnormal bones (congenital) in their feet. Inherited foot type. Foot injuries. Inflammatory or degenerative arthritis causing the protective cartilage that covers your big toe joint to deteriorate. Wearing high heels forces your toes into the front of your shoes, often crowding your toes. Wearing shoes that are too tight, too narrow or too pointed are more susceptible to bunions. Pain from arthritis may change the way you walk, making you more susceptible to bunions. Occupation that puts extra stress on your feet or job that requires you to wear ill-fitting shoes. The tendency to develop bunions may be present because of an inherited structural foot defect.
Symptoms
Movement of the big toe towards the smaller toes. Bulging bump on the outside of the base of the big toe. Restricted movement of the big toe. Swelling, inflammation, redness or soreness around your big toe joint. Persistent or sporadic dull, sharp or aching pain in or around the big toe. Corns, blisters and calluses which can develop when the first and second toes overlap. Over time, more severe symptoms can occur such as arthritis of the big toe, stress fractures and problems walking.
Diagnosis
Generally, observation is adequate to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your physician may order X-rays that will show the extent of the deformity of the foot.
Non Surgical Treatment
The non-invasive treatments for bunions are many and include changes in footwear, icing the sore area, over the counter pain medications, orthotic shoe inserts, and weight management. If these conservative measures fail to arrest your pain and discomfort, your foot and ankle surgeon may recommend a bunionectomy or similar surgical procedure, depending on your condition.

Surgical Treatment
If nonsurgical treatment fails, you may want to consider surgery. Many studies have found that 85 to 90 percent of patients who undergo bunion surgery are satisfied with the results. Reasons that you may benefit from bunion surgery commonly include severe foot pain that limits your everyday activities, including walking and wearing reasonable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain. Chronic big toe inflammation and swelling that doesn't improve with rest or medications. Toe deformity-a drifting in of your big toe toward the small toes. Toe stiffness-inability to bend and straighten your toe. Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person. Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medication. As you explore bunion surgery, be aware that so-called "simple" or "minimal" surgical procedures are often inadequate "quick fixes" that can do more harm than good. And beware of unrealistic claims that surgery can give you a "perfect" foot. The goal of surgery is to relieve as much pain, and correct as much deformity as is realistically possible. It is not meant to be cosmetic.