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Arthroscopic, Robotic, and Open Orthopedic Surgery, Sports Medicine, and Physical Therapy

A bunion is often a painful bony bump that forms over time at the base of either the big toe or the little toe. They develop most comA bunion is often a painful bony bump that forms over time at the base of either the big toe or the little toe. They develop most commonly on the metatarsophalangeal (MTP) joint below the big toe but do occasionally occur on the outside edge of the foot as well. This type of outer-edge bunion is referred to as a tailor’s bunion. Bunions do not occur overnight; it is a slow process where consistent pressure from the way you walk and the inside of the shoe causes the toe to lean inwards. In time this redirecting of the toe causes a change in the structure of the joint. The result of this painful restructuring is called a bunion.

Though anyone can develop a bunion they are most often seen in women, this is due, partially, to the tight fit and narrow shape of most women’s shoes. While bunions can also be seen in children, they are much less likely. Adolescent bunions, as they are referred to, are most prevalent in girls aged 10-15, and are usually the result of a genetic predisposition for deviation of the big toe (hallux valgus deformity).

Vincent J. Inglima, DPM provides treatment for bunions at the Orthopedic Surgery and Sports Medicine Institute at two office locations, Decatur and Fort Worth, Texas. Dr. Inglima is a board-certified foot and ankle surgeon (podiatrist) with the Orthopedic Surgery and Sports Medicine Institute (OSMI).

bunion haul valgus

Diagnosing Bunions

A doctor will likely be able to diagnose a bunion by simply looking at your foot, though an x-ray is often neA doctor will likely be able to diagnose a bunion by simply looking at your foot, though an x-ray is needed to assess how much damage has been done to the joint and evaluate the underlying cause of the bunion.

Anatomy of a Bunion

There are two joints that make up the big toe, the larger and lower of the two joints is called the metatarsophalangeal (MTP) joint and it sits where the last bone of the foot meets the first bone of the there are two joints that make up the big toe, the larger and lower of the two joints is called the metatarsophalangeal (MTP) joint and it sits where the last bone of the foot meets the first bone of the toe. This is where a traditional bunion is seen. As the toe is forced inwards, the MTP joint becomes inflamed. Over time this inflammation leads to more and more swelling, eventually growing into the painful bump that is known as a bunion.

Types of Bunions

There are two joints that make up the big toe, the larger and lower of the two joints is called the metatarsophalangeal (MTP) joint and it sits where the last bone of the foot meets the first bone of the toe. This is where a traditional bunion is seen. As the toe is forced inwards, the MTP joint becomes inflamed. Over time this inflammation leads to more and more swelling, eventually growing into the painful bump that is known as a bunion.

Symptoms of Bunions

  • Pain
  • Swelling
  • Redness
  • Tenderness
  • Bulging lump at the base of the toe
  • Difficulty moving one or all the toes 

Causes of Bunions

Traditionally it has been thought that bunions were almost exclusively caused by wearing shoes that have a restrictive or narrow toe box.  This restrictive shape prevents the toes from maintaining their natural alignment and can lead to a restructuring of the foot.

More recently, research has found that inherited genetic traits relating to foot structure and hypermobility (excess motion) in your foot may be the most likely cause of bunions.  Other causes can include certain inflammatory conditions such as rheumatoid arthritis (RA).

  • Bursitis
  • Hammertoe
  • Metatarsalgia

Treatments for Bunions

While non-surgical treatments can’t reverse the development of a bunion, they can help relieve symptoms of a bunion from developing any further. The most common non-surgical treatments for bunions are:

  • A change in footwear: Ideally you want to find a shoe that has a wide toe box and a comfortable insole that does not irritate the bunion
  • Orthotics: Over-the-counter medical grade inserts and occasional custom orthotics can be used to treat the underlying structural issues causing the bunion
  • Toe splints and toe spacers: These are wedged between the toes and help keep the bones of the toe in proper alignment
  • Padding: Most pharmacies sell protective pads that go over the bunion and help cushion the painful area from the inside of the shoe. It should be noted, however, that these pads can occasionally increase the pressure on the bunion and worsen symptoms. Be sure to test them out before wearing them for long periods of time

Surgery for Bunions 

If all the non-invasive remedies mentioned above have failed and you are still having pain, surgery may be indicated. If you and your surgeon decide that bunion surgery is right for you, there are several possible procedures.  While it is possible to simply “shave the bump,” in most cases, addressing the root of the issue is the best option for bunion surgery and gives our patients the best result with a low likelihood of recurrence.  This is a discussion you and your surgeon will have together.

What was once a slow, drawn-out recovery after surgery has improved dramatically in the past several years.  Using the most advanced technologies available, our surgeons can get you back on your feet within 2-3 weeks after surgery and back to full activity quickly after your bunion surgery.  

3MD