Bunions 101: What You Need to Know About this Common Toe Condition

What Is A Bunion?

A bunion is one problem that can develop due to hallux valgus, a foot deformity. The term "hallux valgus" is Latin and means a turning outward (valgus) of the big toe (hallux). The bone which joins the big toe, the first metatarsal, becomes prominent on the inner border of the foot. This bump is the bunion and is made up of bone and soft tissue.

What Causes Bunions?

By far the most common cause of bunions is the prolonged wearing of poorly fitting shoes, usually shoes with a narrow, pointed toe box that squeezes the toes into an unnatural position. Heredity may also play a role in bunion formation. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men.

Can Bunions Be Prevented?

Bunions often become painful if they are allowed to progress. But, not all bunions progress. Many bunion problems can be managed without surgery. In general, bunions that are not painful do not need surgical correction. For this reason, orthopaedic surgeons do not recommend "preventive" surgery for bunions that do not hurt; with proper preventive care, they may never become a problem.

Bunion pain can be successfully managed in the vast majority of cases by switching to shoes that fit properly and don't compress the toes.

• Do not select shoes by the size marked inside the shoe.
• Have both feet measured regularly as size may increase with age and most people have one foot larger than the other. Choose a size to fit to the larger foot.
• Fit at the end of the day when your feet are the largest.  Stand during the fitting process and check that there is adequate space (3/8" to 1/2") for your longest toe at the end of each shoe.
• Make sure the ball of your foot fits well into the widest part (ball pocket) of the shoe.
• Do not purchase shoes that feel too tight, expecting them to "stretch" to fit.
• Your heel should fit comfortably in the shoe with a minimum amount of slippage.
• Walk in the shoe to make sure it fits and feels right. (Fashionable shoes can be comfortable.)

Is Bunion Surgery For You?

If nonsurgical treatment fails, you may want to consider surgery. Many studies have found that 85 to 90 percent of patients who undergo bunion surgery are satisfied with the results.