A bunion is a hard, bony prominence that forms at the base of the big toe along the side of the toe joint. It develops when the toe joint is pushed out of its normal position over time, usually as a result of “sideways” pressure on the upper portion of the toe. As the toe is pushed inward, the joint gradually becomes stretched and deformed, resulting in a bony lump at the base of the toe. Over time, bunions can become large and painful, making it difficult to find shoes that fit comfortably and resulting in considerable pain. Without treatment, the joint can eventually become arthritic and stiff, and in some cases, the toe may cross over adjacent toes as the joint becomes severely deformed.
Bunions are most commonly associated with wearing shoes that are too tight in the toe area or with the frequent wear of high heels that cause the toes to slide downward into the tighter toe portion of the shoe. They can also occur in people with certain foot shapes or, less commonly, as a result of injuries.
If caught early before the joint has a chance to stiffen, some bunions respond well to a change in footwear to include shoes that have a broader or wider toe area so the toes are not crowded. Wearing a splint while sleeping can help provide support to the joint, gently shifting it back into its normal position. Pain relievers can also help with discomfort, and massaging the joint can help keep it flexible as it returns to its normal position. When these conservative approaches aren’t sufficient to enable the toe to resume its normal position or when the bunion is in a more advanced stage, surgery may be required to restore the joint’s position. During the procedure, a small amount of bone may be removed from the joint and pins may be used to hold the joint in place. Sometimes, the joint is permanently fused to prevent it from moving.