CNY Orthopedic Sports Medicine, PC: Injury: Bunions

Injuries and Conditions: Foot/Ankle/Heel: Bunions

A bunion is a sore bump on the joint connecting the big toe to the foot. The condition is the result of a progressive malalignment of the big toe and the connecting metatarsal bone of the foot. The bump on the interior (inside) of the foot is most often caused by shoes angling the big toe toward the outside of the foot (squeezed into the other toes), which forces the skeletal structure into an unnatural position.
  • Bunions range in severity from a painful bump, to misalignment of the first two toes, to severe pain that can prevent walking and cause arthritis.
  • Bunions are largely the result of pointed-toe shoes that force the big toe into an unnatural position. Though outwardly attractive, women's high heels and cowboy boots are the most serious offenders.
  • Ninety percent of bunions occur in women; a statistic that correlates to the shape of the typical women's dress shoe.
  • Young teenagers can develop bunions that are painful but allow movement of the affected joint. These are generally treated with wider shoes having more spacious toe boxes (the front portion of the shoe).
  • Bunion treatment typically begins with adapting shoe wear to include only those with a spacious and square toe box. Special pads may be used to protect the bunion, and toe spacers can splint and eventually readjust a slightly misaligned toe.
  • Extreme cases necessitate surgically removing the bunion, realigning the bone of the big toe, or cutting and realigning the metatarsal bone in the foot where the big toe attaches. When the bone is repositioned, it is usually held in place with screws or pins.

  • Signs and Symptoms
  • A painful, sometimes red, bump on the inside of the foot where the big toe connects to the foot.
  • Thickening or callous skin on the bottom of the foot near the formation site of the bunion.
  • Crossing of the second toe over the third may suggest an associated condition of pain with malalignment of the metatarsals, known as metatarsalgia.
  • Contact the Doctor if ...
  • Toes are misaligned and walking is painful.
  • Pain persists when shoes are modified in width and height: the toe box should be roomy and heels should never exceed two and a quarter inches.

  • Common Causes of Injury
  • Shoes with pointed toes such as pumps or cowboy boots.
  • Shoes with heels over two and a quarter inches.
  • Ill-fitting shoes, particularly those that are too small.

  • Expectations of Recovery
  • If a bunion is minor or new, consistently wearing shoes that fit properly should lessen the probability that the condition will progress.
  • Surgical treatment focused on bunion removal should result in decreased foot pain and an improved appearance of the foot.
  • Surgical recovery is approximately 8 weeks when bone realignment is required.


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