Bunions 101

A bunion is a localized swelling or enlargement of the outer portion of the joint of the big toe. The enlargement is due to additional bone formation often with a combination with misalignment of the toe joint. The condition usually progresses slowly but is visibly quite obvious. The majority of individuals who develop a bunion complain of pain in the big toe.

Bunions are common in women and this is most likely associated with the wearing of tight fitting shoes, especially high heel shoes with narrow toes. Overall, bunions are more common in people who wear shoes compared to those who are barefoot. There does appear to be a genetic link that predisposes one to bunion formation. Other risk factors that may contribute to bunion formation include abnormal joint anatomy, nerve injury, rheumatoid arthritis or some type of traumatic injury to the foot; bunions are also far more common in dancers and sports athletes who wear tight shoes.

While some bunions may not cause symptoms, the majority of patients will complain of pain on walking or while wearing tight shoes. Once the pain starts in the joint, it will always progress if the shoes are not altered. Associated with pain is the presence of toe swelling, redness and abnormal alignment of the joint.

The diagnosis of a bunion is straightforward. The physical exam is almost always diagnostic but most physicians will obtain x rays to confirm integrity of the joint and presence of any underlying condition like arthritis or gout. Prior to any surgery, x rays are essential.