What are bunions?

In sandal or boot season, you may be thinking that it’s about time to do something about that large bump sticking out near your big toe.

That painful, bony bump is what doctors call a hallux valgus, or what is more commonly known as a bunion.

Hallux valgus vs. hallux rigidus

Some of the complex medical terms in orthopedics can be confusing for patients. Below is an outline, with photos, of what a hallux valgus (bunion) and a hallux rigidus are.

Figure 1 (left): Hallux valgus, the “bump” is on the inside of the big toe. Patient with a hallux valgus deformity, this is a classic photo of a bunion, notice that the bump is on the inside of the big toe.

Figure 2 (right): Hallux rigidus, the “bump” is on the top of the big toe joint, metatarsophalangeal joint (the MTP joint). This is an arthritic condition, where cartilage in the joint is lost, and abnormal motion creates bone spurs, or osteophytes. Intraoperative photograph of a procedure in a patient with severe hallux rigidus, joint destruction and bone spurs.

Mechanics of bunions (hallux valgus)

Bunions are formed when the big toe is forced to bend toward the others instead of pointing straight ahead—the bone or tissues at the joint at the bottom of the big toe move out of place.

Over time, this abnormal motion and pressure on the joint can throw the bones out of alignment and produce a painful lump of bone known as a bunion.

If bunions are not corrected, they can cause skin irritation in adjacent toes, skin breakdown and painful arthritis, which can make walking painful.

Possible causes of bunions graphic

Possible causes of bunions

• Bunions can often run in families—people who have low arches of flat feet are more susceptible.
• They can also develop from a foot injury or having an inflammatory condition such as rheumatoid arthritis.
• Shoe wear: High heels or shoes that are pointed and too tight may also be to blame.
• Other causes can include genetic disorders or neuromuscular conditions.

Symptoms of a bunion can include

• pain and tenderness
• redness and inflammation
• hardened skin on the bottom of the foot
• a callus or corn on the bump
• stiffness and restricted motion in the big toe, which may lead to difficulty in walking or wearing shoes

If your foot pain starts to interfere with daily activities, it’s important to schedule an appointment with an orthopedic foot specialist to determine if it’s a bunion, or another condition. If a bunion is discovered, your doctor will discuss your options.

Non-surgical treatment options

• Change shoes—well-fitting shoes with wide toe boxes to give feet more space.
• Padding, taping or splinting—purchase over-the-counter bunion pads, or ask your doctor to help you tape your foot in a normal position.
• Medications—take acetaminophen (Tylenol), ibuprofen (Advil) or naproxen sodium (Aleve) can help with the pain.
• Ice/massage—icing your feet can help relieve soreness and inflammation, as can massaging the feet or using a warm soak/whirlpool.
• Shoe inserts—over-the-counter arch supports or prescription orthotic devices can provide relief for some.

When conservative approaches don’t work, or you’ve felt pain for more than a year, surgery is another option. Bunions can result in other painful foot problems including hammertoes, bursitis, a bunion below the little toe (a bunionette), or pain in the balls of your feet.

The goal of bunion surgery is to return the big toe to its correct position. There are several surgical procedures to correct bunions and can include realigning bone, ligaments, tendons, and nerves so that the big toe can be brought back to its correct position.

Many bunion surgeries are done on a same-day basis with no stay at Campbell County Memorial Hospital.