Understanding Bunions

Between 10 and 25% of Americans have bunions, and up to one-third of adults in the U.S. will experience them during their lifetimes. The medical term is hallux valgus, but by any name, they can be painful and make it hard to walk. 

What are bunions?

A bunion is a bony, painful lump that forms at the base of the big toe, at the metatarsophalangeal joint. It is the result of the big toe pointing inward, toward the other toes. This causes the base of the big toe to jut out and become enlarged. Bunions can cause pain, swelling, and redness at the base of the big toe, as well as calluses, which can make walking painful. Bunions can also cause the other toes to become misshapen and painful.

What causes bunions?

Bunions are most commonly caused by poorly-fitting shoes, especially shoes that are too tight. High heels and narrow toes can push the toes into unnatural shapes. Over a period of years, they become painfully deformed. Catching them early can help lessen pain.

About 70% of people who suffer from bunions have a family history of this condition. This suggests that there may be a genetic component. People with naturally flat feet or low arches may be more susceptible. However, some of the risk factors are within your control. 

Choosing comfortable, supportive shoes is the most important thing you can do to avoid hallux valgus. Obesity also increases your risk. The condition also shows up in ballet dancers, though, because of the extreme stress the art puts on the feet. Any job that keeps you on your feet all day can increase the risk.


Mild cases of bunions can often be treated with simple lifestyle changes, such as wearing shoes that fit properly and avoiding tight-fitting shoes. Over-the-counter pain medication, such as ibuprofen or acetaminophen, can reduce the pain associated with bunions.

For more severe cases, your doctor may recommend surgery to correct the deformity. This typically involves cutting and realigning the bones of the big toe joint. In some cases, the surgeon may remove a portion of the bone or cartilage to reduce the size of the bunion. Surgery may also involve implanting metal pins or screws to hold the bones in place.

In addition to surgery, physical therapy may be recommended to help reduce the pain caused by bunions and improve mobility. Physical therapy can include exercises to help strengthen the muscles around the foot, as well as stretching exercises to help keep the foot flexible.

In some cases, a doctor may recommend using orthotic devices, such as shoe inserts or splints, to help reduce the pain and pressure associated with bunions. Orthotic devices can be used to help support the foot and the big toe joint, as well as to cushion the area and reduce friction.

Bunions can be a painful and unsightly condition, but there are treatments available that can help reduce the associated discomfort. If you are experiencing any pain in your feet, it is important to speak to your doctor to determine the best course of treatment. Your doctor might refer you to a physical therapist.