If you’re like many people, your big toe may lean slightly toward your other toes. Over time, the base of the big toe pushes outward against the first metatarsal bone, which is directly behind it. The result is a bunion — a bony, often painful hump at the base of the big toe.

Bunions form at a joint. That’s where the toe bends normally when you walk. But when you have a bunion, all of your body weight rests on it each time you take a step. It can hurt when you walk. And, because your shoe likely rubs against it, a bunion can also cause calluses to form.

Causes

Foot problems typically start in early adulthood. As we age, our feet spread, and the problems tend to get worse. Bunions can run in the family. They may be just one of many problems caused by weak or poor foot structure. Sometimes, they develop with arthritis. If one of your legs is longer than the other, you may develop a bunion on the big toe of the longer one.

Women are more likely to get them than men. That’s because wearing tight shoes and especially high heels pushes the foot bones into an unnatural shape over time.

When should you make an appointment to see me?

If you think you have a bunion or you think one is forming, start with self-care. Wear wider shoes, use inserts for arch support and place gel padding around your bunion. If your bunion becomes painful or inflamed, ice it several times a day to reduce swelling.

If your pain worsens or walking becomes unstable, you need to make an appointment to see me.

I Initially may recommend some conservative treatments such as pads and tape to help your foot keep its normal position. I may also consider trying anti-inflammatory drugs and cortisone injections to minimize inflammation. The use of orthotics to control the abnormal motion in your feet is also a possibility.

For more severe bunion issues I might suggest one of the following surgeries:

• Bunionectomy – I remove part of the bone causing the bunion and reposition it to restore alignment of your big toe joint.
• Joint Replacement Surgery – If your joint is damaged beyond repair, I can replace it with an artificial joint.
• Fusion Surgery – In severe cases, fusing the joint associated with your bunion so that it won’t move might be an option. The caveat is that after fusion surgery, you may not be as athletically active as you were before.

If you want to try avoiding surgery have your bunion cared for right away because the longer it persists, the more likely surgery will be the best option.