Bunions (Hallux Valgus)

What is a bunion?

A bunion is a bony bump that forms at the base of your big toe. Bunions develop on the inside edge of your big toe joint — the metatarsophalangeal (MTP) joint. The MTP joint is where the base of your big toe meets your foot. The medical term for bunions is hallux valgus.

Visit a healthcare provider if you notice a bump on your big toe, especially if you’re experiencing pain, stiffness or numbness in your toes or feet.

Types of bunions

Bunions on your big toe from extra pressure are the most common, but they can form on other toes and for other reasons, too. Other types of bunions include:

• Congenital bunions (congenital hallux valgus): Some babies are born with bunions.
• Juvenile or adolescent hallux valgus: These are types of bunions that affect people younger than 18.
• Tailor’s bunion (bunionettes): Tailor’s bunions form at the base of your little (pinky) toe. They’re usually the result of wearing shoes that don’t fit correctly or doing an activity that presses your little toe in toward your other toes.

How common are bunions?

Bunions are very common. Experts estimate that around one-third of Americans have bunions.

What are the symptoms of a bunion?

The most obvious symptom of a bunion is the growth that forms at the base of your big toe. You can usually see and feel the bony bump. A bunion can cause other symptoms, including:

• Pain or stiffness in your big toe.
• Swelling.
• Discoloration or redness.
• An inability to move or bend your big toe (you might feel pain or a burning feeling when you bend your toe).
• Difficulty wearing certain types of shoes, or pain that gets worse when you’re wearing shoes.
• Corns or calluses (thickened skin).
• Hammertoes (painful, tight toe tendons and joints).
• Numbness in or around your big toe.

What causes bunions?

There’s not just one reason why bunions develop. It’s thought that a combination of factors — like family history, abnormal bone structure, increased motion and shoe choice — can cause them. When something puts extra pressure on your big toe joint for a long time (usually years), that pressure can push your joint out of its natural alignment and toward your other toes. Eventually, a bunion forms on your MTP joint when your body compensates for your toe being pushed out of its usual place.

The most common causes of extra pressure on your big toe joint include:

• Wearing narrow or pointed shoes that crowd your toes (shoes with a narrow toe box).
• The way you walk (your foot mechanics).
• Health conditions that cause inflammation (like rheumatoid arthritis or lupus).
• Standing for a long time or working on your feet.

Risk factors

Anyone can develop a bunion. Certain groups of people who are more likely to have bunions include:

• People assigned female at birth (AFAB).
• People whose biological parents have bunions or issues with their foot mechanics. More than 70% of people with bunions have a biological parent who’s had them.
• People with a history of foot injuries (including athletes).

Complications of bunions

Having a bunion may increase your risk of:

• Bursitis (painful, fluid-filled sacs around joints).
• Hammertoes.
• Osteoarthritis.

How are bunions diagnosed?

A healthcare provider will diagnose a bunion with a physical exam. They’ll examine your foot and ask about your symptoms. Tell your provider when you first noticed a bump near your big toe or if certain activities make your symptoms worse.

You might need to visit a podiatrist — a provider who specializes in caring for your feet.

What tests are done to diagnose bunions?

You may not need any tests for your provider to diagnose a bunion. Your provider will use foot X-rays to determine the overall alignment of your bones and your MTP joint.

How are bunions treated?

The most common bunion treatments include:

• Footwear changes: Switching to shoes with wide, deep toe boxes can take pressure off your toes. You may be able to use a stretching device to widen shoes you already own.
• Bunion pads and taping: Over-the-counter (OTC) bunion pads cushion the area around a bunion to relieve pressure. Your provider might suggest using medical tape to hold your toes in the correct position.
• Orthotic devices: Orthotics are shoe inserts that support your feet. You might need over-the-counter orthotics or custom-made inserts. Your provider might suggest placing a spacer between your big toe and second toe, too. You may need to wear a splint to keep your big toe straight when you’re not wearing shoes.
• Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and swelling. You might need pills you take by mouth or topical NSAIDs (creams or ointments you rub into your skin around a bunion). Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
• Icing: Applying ice or cold packs to your affected toe may also help. Wrap a cold pack in a thin towel to avoid putting it directly onto your skin.
• Corticosteroids: Corticosteroids are prescription medications that reduce inflammation.
• Physical therapy: You may need to work with a physical therapist to strengthen your foot. They’ll give you exercises or stretches that may help your toes stay in better alignment.
• Surgery: Your provider may recommend bunion correction surgery if other treatments don’t relieve your symptoms or walking is extremely painful. Your provider or surgeon will tell you which type of surgery you’ll need and what to expect.

Do bunions go away on their own?

No, bunions don’t just go away and you can’t fix bunions on your own. See a healthcare provider or podiatrist if you have a bunion. They’ll diagnose it and suggest treatments to relieve your symptoms.

How can I prevent a bunion?

Since bunions are caused by a combination of several different reasons, they can be difficult to prevent. That being said, wearing well-fitting shoes may help reduce the progression of bunions. In general, follow these tips to find comfortable shoes that fit your feet properly:

• Avoid shoes with narrow, pointed tips — especially if they fit tightly on your toes.
• Even if you know your size, try on a few pairs of shoes to make sure you’re getting the best fit. Labeled shoe sizes aren’t always the same between brands and styles.
• Sit, stand and walk in new shoes before buying them. Make sure no movement or position hurts, pinches or pushes on your toes.
• Trying shoes on at the end of the day may give you a more accurate fit (your feet naturally swell slightly over the course of a day and are bigger later in the day than they are first thing in the morning).

Your provider or podiatrist can recommend types or brands of shoes that’ll work well for your feet. If you have other structural foot issues like flat feet or high arch feet, ask your provider whether you need orthotics to prevent bunions.

What can I expect if I have bunions?

Most people with bunions are able to manage their symptoms with few long-term impacts to their daily routine. Your provider will work with you to find a combination of treatments to relieve your symptoms and keep your feet and toes healthy and strong.

Don’t wait to see a provider if you have bunion symptoms. The sooner you start treatment, the more likely it is you’ll be able to manage your symptoms without surgery.

People who need bunion surgery can usually resume all their usual activities in two to three months.

When should I see my healthcare provider?

Visit a healthcare provider or podiatrist as soon as you notice any of the following symptoms:

• Pain in your foot or toes.
• Difficulty walking or moving.
• A noticeable bump near the base of your big toe.
• Swelling in or around your toes.

What questions should I ask my healthcare provider?

1. Why did I get a bunion?
2. Which treatments will I need?
3. How can I prevent developing a bunion on my other foot?
4. Do I need to avoid certain types of shoes?

A note from Cleveland Clinic

Bunions are a common foot issue. They happen when something pushes your big toe out of its natural alignment and toward your other toes. Eventually, a bony bump can form on the joint where your big toe meets your foot.

Bunions need treatment if they cause pain. Even if it’s a simple solution like changing the kinds of shoes you’re wearing, you still need to see a healthcare provider or podiatrist to diagnose a bunion. Your provider will suggest treatments that’ll relieve your symptoms and help you get back to the activities you love.