A bunion is a deformity of the big toe. The big toe tilts toward the smaller toes and a "bump" develops at the base of the big toe. In some people the deformity of a bunion grows very rapidly, while in others progression is very slow or not at all. Bunions are more common in women.
The medical name for a bunion is Hallux Valgus. Hallux is the term for the big toe and valgus is an anatomic term for the rotation of the toe.
Footwear such as tight-fitting shoes or heels may contribute to the development of the bunion deformity but other factors such as very flexible joints or a family history of bunions appear to be more important risk factors. Bunions can also be caused by injuries to the foot, various forms of arthritis and certain neuromuscular disorders, such as cerebral palsy.
Shoes that squeeze the big toe or do not fit properly or have an excessive high heel can contribute to the deformity of a bunion in people who are already at increased risk. Such shoe wear can also cause pain or worsen the deformity of a bunion.
In addition to a bump at the base of the big toe, people with a bunion may notice decreased motion of the big toe and swelling, redness or soreness in the area around the bump. As the deformity of the bunion worsens, the first and second toes overlap. Pain symptoms can range from none at all to very severe.
Bunions often require no treatment and surgery should generally only be considered when there is persistent pain or severe deformity.
Nonsurgical treatment to relieve the pain of a bunion include wearing roomy and comfortable shoes, using soft protective pads over the bunions and getting padded shoe inserts or orthotics.
Studies have shown that 15 percent or more of people who have bunion surgery remain dissatisfied with the end results. Pain can persist even after surgery. Always discuss with your physician all the complications of bunion surgery.
If you have a bunion and there is no pain associated with it, and the deformity is not severe, I would recommend not having surgery.
This was a recent article by Dr. Dennis Cardone that appeared in The Star Ledger, NJ