A bunion is a firm, fluid-filled pad overlying the inside of the joint at the base of the big toe (metatarsophalangeal joint). The pad (bursa), which may get larger and stick out, can become inflamed and painful. Bunions may run in families, but many result from wearing tight shoes. Nine out of 10 bunions are developed by women. Nine out of 10 women wear shoes that are too small. Tight shoes also can cause other disabling foot problems like corns, calluses and hammertoes.
The skin over your big toe may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. If this condition gets severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.
A thorough medical history and physical exam by a physician is necessary for the proper diagnosis of bunions and other foot conditions. X-rays can help confirm the diagnosis by showing the bone displacement, joint swelling, and, in some cases, the overgrowth of bone that characterizes bunions. Doctors also will consider the possibility that the joint pain is caused by or complicated by:
Your doctor may order additional tests to rule out these possibilities.
If your bunion has progressed to the point where you have difficulty walking, or experience pain despite accommodating shoes, you may need surgery. Bunion surgery realigns bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. Orthopedic surgeons have several techniques to ease your pain. Many bunion surgeries are done on a same-day basis, requiring no hospital stay, using an ankle-block anesthesia. A long recovery is common and may include persistent swelling and stiffness.
Reviewed by health care specialists at UCSF Medical Center.