Bunions affect the big toe where it attaches to the foot. Why they are called bunions is not clear, but may be related to the old Middle French word ‘buigne’ meaning bump (such as on the head).
Bunions are a swelling of the soft tissues at the base of the big toe, where it attaches to the foot. The swelling may or may not be painful. Besides the swelling, the big toe angles to the outside of the foot, sometimes pushing against the second toe.
Many possible causes of bunions include unusual toe bone length, heredity, flat feet, stresses on the foot (ballet dancers), excessive wearing of tight shoes or pointed boots, leg length differences, rheumatoid arthritis and possibly other genetic reasons.
The bunion may be very tender and sometimes warm or even red in color. Although painful, it is not as painful as a gout attack, which often happens in the same area.
X-rays can determine if the big toe joint also is involved with arthritis, and help to measure the abnormal angle of the toe.
Treatment depends on the amount of pain and disability the bunion causes. Changes in shoes, activities, physical therapy may be tried. If bursitis is present in the area, a cortisone injection can provide some relief, but often the swelling will not change. Of course any underlying disease or condition such as rheumatoid arthritis should be treated. In the later stages, bunions may cause bony growth around the joint of the big toe, and even affect the joint itself. Various toe braces may help to relieve pain or pressure and temporarily reduce the abnormal angle of the big toe.
Medications such as ibuprofen or naproxen may help the pain, but may cause side effects especially if taken continually. Sometimes over-the-counter or prescription anti-inflammatory medications or creams are very helpful.
If other treatments are not effective, or if the bunion is severe, surgery may correct the swelling and straighten the big toe.