Bunions are bony lumps that project from the base of the big toe, right where it joins with the foot. As the bunion grows, it pushes the big toe out of its normal position, creating a lump that rubs against shoes and causes pain, especially when walking. Often, calluses or blisters will form along with the bunion. Without care, the bunion will continue to develop, eventually causing the joint to become deformed and arthritic, and often causing the big toe to cross over neighboring toes or force them out of alignment as well.
The specific cause of bunion formation is not well understood, but medical research has shown the condition tends to run in families, and it also occurs more often in people with leg length disparities. Arthritis can also contribute to the formation of a bunion, and long-term use of high heels are also a primary contributor. Some younger people develop bunions as their feet grow and spread, and footwear causes increased crowding that pushes the joint out of its normal position.
When bunions are caused by tight shoes and are in their earliest stages, they may resolve by changing to a better-fitting shoe and avoiding high heels and shoes with small or pointy toe areas, or with the use of custom inserts or orthotics designed to prevent friction and gently coax the joint back into its normal position. Gentle stretching exercises can also help prevent the joint from becoming stiff and arthritic. When these conservative approaches fail to provide relief, surgery may be necessary to reposition the joint. During the procedure, one or two small incisions are made over the joint so the bone can be reshaped and repositioned. Once surgery is complete, a splint or cast may be worn to support the toe and encourage proper healing.