Bunions (Hallux Valgus) – Symptoms, Causes, Treatments, Surgery and Recovery

Hallux Valgus, or bunions as they’re widely known, are bony lumps that form on the side of your feet. They are very common and most people learn to live with them by making a few simple adjustments like wearing wider shoes. However, sometimes they become sore and painful and if they start affecting your daily life, surgery may be an option. This article explains more about what causes bunions, the main symptoms, and treatment options.

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A bunion is a bony bump that develops on the inside of your foot at the base of your big toe. This joint is known as the metatarsophalangeal joint (MTP) and helps to distribute body weight on your foot when you’re walking, running, or standing.

Bunions form when some of the bones at the front of your foot move out of place. This usually happens slowly, causing your big toe to move towards the smaller toes and forcing the MTP joint to stick out. This condition, which is also known as the hallux valgus deformity, can gradually worsen over time and may start to become painful.

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Common Symptoms

The most common symptoms of bunions are:

• Your big toe points toward your second toe, or your second toe overlaps your big toe.
• A prominent bump on the inside of the big toe joint.
• Pain on the inside of your foot at the big toe joint when wearing shoes.
• Pain when walking.
• Redness, swelling, or thickening of the skin on the inside of the big toe joint.

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Bunions are a common condition, affecting around one in three people over the age of 65[i]. Women are more likely to be affected than men because they often wear tight, high-heeled shoes that squeeze the toes together. While experts can’t agree on whether wearing tight shoes actually causes bunions in the first place, they are known to make the problem worse. Bunions are rare in populations that don’t wear shoes.

Bunions often run in the family so sometimes it’s simply down to genetics and there’s nothing you can do to prevent them. If you have arthritis, weak connective tissue, short Achilles tendons or calf muscles, or a joint condition, you’re also at a greater risk. Bunions seem to develop faster in people who are flat-footed.

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Your doctor can usually diagnose bunions simply by examining your foot. However, they may order an X-ray to get a clearer diagnosis on how severe the condition is. They will ask you about your symptoms and watch you walking around to get a feel for your level of discomfort and how much it’s affecting your day to day life.

Most people find relief from bunion pain by simply changing the type of shoes they wear. Get your feet measured to make sure you’re wearing the right size and choose comfortable, wider shoes that give your feet and toes ample room to move. If your big toe has plenty of space, it’s less likely to start moving towards the smaller toes. Avoid any heels higher than two inches as this can put too much pressure on the front of your foot.

Tips for proper shoe fit:

• Size varies among brands, so judge the shoe by how it fits on your foot rather than the size marked on the shoe.
• Find a shoe that’s similar to the shape of your foot.
• Measure your feet regularly. The size tends to change as you grow older.
• Your feet may be different sizes. If so, fit to the size of your largest foot.
• Be sure to stand during the fitting process.
• Make sure you can extend all of your toes and that there’s adequate space for your longest toe.
• Walk in the shoe to make sure it feels right.

You can also try bunion pads, which are soft pads made from silicone, to line the area that presses against the bunion, helping to relieve pain and preventing further bunion growth.

Some doctors recommend using shoe inserts (orthotics). They work by ensuring your foot is properly aligned and reducing pressure on your bunion. Orthotics can be bought over the counter or custom-made for your feet.

Taping your bunion can also reduce the amount of pressure on the inflamed joint and ensure that your foot is properly aligned. A medical professional or physical therapist can demonstrate the most beneficial and proper taping technique.

Over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, and naproxen can help to ease bunion inflammation and pain. Using an ice pack can also help. Wrap a bag of frozen vegetables or ice in a towel and hold it over the area for around five minutes. Don’t use ice on your foot for longer than 20 minutes because this can damage your skin.

Other, less common treatments include a castor oil wrap, cortisone injections and acupuncture. Castor oil is an anti-inflammatory and analgesic (pain reliving) holistic remedy and has been known to relieve the pain caused by bunions. Wrap a cloth soaked in castor oil around your foot, ensuring that the castor oil is in contact with the bunion. Then wrap your entire foot with plastic wrap and place a hot compress on the inflamed area for around 30 minutes.

Taping your bunion can also reduce the amount of pressure on the inflamed joint. Likewise, taping will help ensure that your foot is properly aligned. Consider visiting a medical professional or physical therapist to demonstrate the most beneficial and proper taping technique.

Anti-inflammatory Medication: Over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, and naproxen can help to ease bunion inflammation and pain

Hot/Cold Bunion Therapy: Alternating ice and applying heat to a bunion can provide temporary pain relief caused by a bunion and may also help to reduce any swelling or bursitis in the big toe joint.

Castor Oil. Castor Oil is known as an anti-inflammatory and analgesic (pain reliving) holistic remedy and has been known to relieve the discomfort resulting from a bunion.  Wrap a castor oil-soaked cloth around the foot ensuring the castor oil is in contact with the bunion. Then wrap the entire foot with plastic wrap. Finally, place a hot compress on the inflamed area for approximately 30 minutes.

Cortisone Injections: Inflammation of the joint at the base of the big toe and the pain associated with it can sometimes be relieved with a local injection of cortisone, a strong steroid used to reduce inflammation.

Acupuncture: This Chinese medical practice involving the insertion of needles at specified sites of the body has been shown to alleviate the pain caused by bunions.

1. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Bunions: Overview. 2018 Jun 28. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513134/
2. Patient Preference and Physical Demand for Hands-Free Single Crutch vs Standard Axillary Crutches in Foot and Ankle Patients. Kevin D. Martin, DO, Alicia M. Unangst, DO, Jeannie Huh, MD, Jamie Chisholm, MBA. Foot Ankle Int. 2019 Oct;40(10):1203-1208. Epub 2019 Aug 2.
3. Unilateral Versus Bilateral Same-Day Surgery Outcomes for Hallux Valgus: An Eight Year Prospective Cohort Study By Jill Dawson, DPhil, Michele Peters, PhD, Crispin Jenkinson, DPhil, Helen Doll, DPhil, Grahame Lavis, BSc (Hons), Robert Sharp, MA FRCS (Ortho), Mark Rogers, FRCS (Ortho), Paul Cooke, ChM FRCS, The Foot and Ankle Online Journal (11): 2 2012.
4. Wiley – Blackwell. “Prevalence of bunions increases with age; more common in women.” ScienceDaily. ScienceDaily, 25 February 2011.