Bunions

A bunion looks like a bump on the inside of the foot where the big toe joins the foot. Over time, the bunion gets worse. The big toe starts to lean toward neighboring toes instead of pointing straight ahead. (The scientific name for this is hallux valgus or hallux abducto valgus.)

The bump is a sign that the bones of the foot are out of alignment. While shoes with high heels or pointed toes may cause the joint to ache, they don't cause bunions. Most often they are due to an inherited foot structure. The tendons and ligaments that hold bones and muscles together at the joint are not working as they should. This structure makes it more likely that a person will develop a bunion.

Tight-toed shoes and high heels may make the deformity more noticeable. They also may make the deformity get worse faster.

Bunions develop slowly. At first, the big toe may slightly lean toward the next toe. As the years pass, the lean gets more obvious and the bump develops at the joint. The bump gets more and more pronounced over time.

Women tend to suffer from bunions more often than men, probably because of the shoes they wear. But besides shoes, standing on the feet for long periods of time can also make symptoms of a bunion worse. Along with the bump, these bunion symptoms include pain or soreness, swelling, redness around the joint, a burning sensation or sometimes numbness. The big toe may develop calluses or not be able to move as well as it once did. Sores between the toes and ingrown toenails may also occur because of a bunion.

Relief for Bunion Symptoms

Several things can be done to help relive the pain of bunions. These won't make the bunion go away, but they can make the foot more comfortable:

  • Wearing different shoes. Shoes with a wide toe box rather than a pointed one will help. Shoes with lower heels will also help. (High heels throw more of the body's weight on the front part of the foot where the toe joints are.)
  • Padding. Pads placed over the bunion may help reduce the pain. These are available from a drug store or may be available from a foot and ankle surgeon.
  • Avoiding activities that make the pain worse. This includes standing for a long time or other activities that make the bunion sore.
  • Non-steroidal anti-inflammatory drugs. These include aspirin or ibuprofen. They relieve pain and swelling.
  • Applying an ice pack to reduce swelling and pain.
  • Corticosteroid injections. These are not often used in bunion treatment. Injecting corticosteroids sometimes helps if the bursa is inflamed. (Bursa is a fluid-filled sac within a joint to cushion the bones.)
  • Orthotic devices. These are devices placed inside a shoe that shift the positioning of the foot. Orthotics help compensate for structural issues that cause foot problems.

Surgical Options for Treating Bunions

While traditional surgery to treat bunions usually requires a six- to eight-week recovery period, new options at the Foot and Ankle Center at the Cedars-Sinai Orthopaedic Center use minimally invasive techniques.

These techniques usually mean less pain, a faster recovery and fewer complications.

Two approaches to correcting bunions are shown in the animations below.

This procedure uses a plate to hold the bone in the proper position:

In the second approach, a specially designed screw is used to hold bones together after the abnormal bony parts of the joint have been removed and the bones realigned: