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Bunions

Hallux valgus

 

A bunion forms when your big toe points toward the second toe. This causes a bump to appear on the inside edge of your toe.

Causes

 

Bunions are more common in women than men. The problem can run in families. People born with abnormal bones in their feet are more likely to form a bunion.

Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion.

The condition may become painful as the bump gets worse. Extra bone and a fluid-filled sac grow at the base of the big toe.

 

Symptoms

 

Symptoms may include:

  • Red, thickened skin along the inside edge at the base of the big toe.
  • A bony bump at the first toe joint, with decreased movement in the toe site.
  • Pain over the joint, which pressure from shoes makes worse.
  • Big toe turned toward the other toes and may cross over the second toe. Corns and calluses develop as a result where the first and second toes overlap.
  • Difficulty wearing regular shoes.

You may have problems finding shoes that fit or that do not cause pain.

 

Exams and Tests

 

A health care provider can very often diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.

 

Treatment

 

When a bunion first begins to develop, take good care of your feet.

  • Wear wide-toed shoes. This can often solve the problem and prevent you from needing more treatment.
  • Wear felt or foam pads on your foot to protect the bunion, or devices called spacers to separate the first and second toes. These are available at drugstores.
  • Try cutting a hole in a pair of old, comfortable shoes to wear around the house.

If the bunion gets worse and more painful, surgery may help. The surgery bunionectomy realigns the toe and removes the bony bump. There are more than 100 different surgeries to treat this condition.

 

Outlook (Prognosis)

 

You can keep a bunion from worsening by taking care of it. Try to wear different shoes when it first starts to develop.

Teenagers may have more trouble treating a bunion than adults. This may be the result of an underlying bone problem.

Surgery reduces the pain in many, but not all people with bunions. After surgery, you may not be able to wear tight or fashionable shoes.

 

When to Contact a Medical Professional

 

Call your provider if the bunion:

  • Continues to cause pain even after self-care, such as wearing wide-toed shoes
  • Prevents you from doing your usual activities
  • Has any signs of infection (like redness or swelling), especially if you have diabetes
  • Worsening pain that is not relieved by rest
  • Prevents you from finding a shoe that fits

 

Prevention

 

Avoid compressing the toes of your foot with narrow, poor-fitting shoes.

 

 

References

Coughlin MJ, Anderson RB. Hallux valgus. In: Coughlin MJ, Saltzman CL, Anderson RB, eds. Mann's Surgery of the Foot and Ankle . 9th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 6.

Richardson EG. Disorders of the hallux. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 81.

Wexler D, Grosser DM, Kile TA. Bunion and bunionette. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 84.

 
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    A Closer Look

     

     

    Review Date: 3/10/2016

    Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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