If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion.
With bunions, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it.
The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. An advanced bunion may make your foot look grotesque.
If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.
Cause & Symptoms
Bunions develop when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance in pressure makes your big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of your foot.
Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to bunion development. Other causes include:
Inherited foot type
Deformities present at birth (congenital)
Bunions may be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause.
Symptoms often include pain, swelling, and abnormal position of the first toe.
The technical term for bunions is “hallux valgus” (HV). This refers to the first toe or hallux moving away or abducting from the middle of the foot and then twisting in such a way that the inside edge actually touches the ground and the outside edge turns upward. This term describes the deviation of the toe toward the outside part of the foot.
If left untreated, bunions can worsen over time and cause considerable difficulty in walking, discomfort, and skin problems such as corns.
In some cases, a small bursa (fluid-filled sac) near the joint becomes inflamed. This condition is known as bursitis and can cause additional redness, swelling, and pain.
Less frequently, bunions occur at the base of the fifth toe. When this occurs, it is called a “tailor’s bunion” or bunionette.
Your doctor can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling.
After the physical exam, an X-ray of your foot can help your doctor identify the cause of the bunion and rate its severity.
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