Arlington Foot & Ankle Center

Ben Pearl, D.P.M., F.A.C.F.A.S.

N.I.H. Consultant

BUNIONS

What causes a bunion?

A bunion is an enlargement of bone in the joint at the base of the big toe. Bunions are most often inherited. The myth that tight shoes cause bunions is not true – they do not cause bunions but they can aggravate them. Bunions can cause pain, swelling, and skin irritation. Bunions may also affect the adjacent smaller toes. When the big toes start to angle over, the big toe may cause increased pressure on the second toe or the second toe may be pushed upwards out of the way. This causes hammertoes and/or calluses on the smaller toes.

People with flat feet or really flexible feet are more prone to develop problems with bunions. Other causes are injury, rheumatoid arthritis and neurovascular disease. There are several types of bunions and several types of corrections for each.

What are the symptoms?  

The severity of the deformity may not correlate to the degree of pain. For example, a bunion that looks severe may have no pain; while a mild looking bunion may be incapacitating.

Rubbing of shoes may cause a red, inflamed sac of tissue called bursitis. As time goes on pain may develop deep in this joint, limiting walking, exercise or even just standing comfortably. High heeled or pointed shoes will exacerbate these symptoms.

What are the treatment options?

When bunions are causing mild to moderate pain, the simplest solution to try is a wider, more accommodating shoe. This includes lower heels, softer leather, wider toe boxes and gym shoes. Cushions may provide relief from shoe pressure over the prominence. Anti-inflammatory medication may also provide relief.

Copyright 2001, Dr. Pearl. All rights reserved.