An Overview of Bunions

Table of Contents
View All
Table of Contents

A bunion is a bony protrusion that typically juts out from the side of the big toe. It is associated with a condition, known as hallux valgus, where the big toe points inward toward the second toe. Less commonly, a bunion may form next to the small toe, and this is referred to as a "bunionette" or "tailor's bunion." Several factors—some of which can be controlled, some of which can't—make a person more vulnerable to developing bunions.

A healthcare provider can usually diagnose a bunion simply by looking at your foot. Most of the time bunions are treated conservatively with self-care strategies, but surgery may be indicated in some cases.

causes of bunions

Verywell / Alexandra Gordon


If bunion symptoms do occur, they usually develop over time, well after the bump has formed. Symptoms may include one or more of the following:

  • Soreness and/or a burning sensation over the bunion
  • Redness, stiffness, and swelling around the big toe joint
  • Hammertoes or calluses under the ball of the foot
  • Corns or other skin irritations where the first and second toes overlap


While the precise cause of bunions has not been completely sorted out, experts believe that certain foot types make a person more prone to developing bunions, and these foot types tend to run in families.

More specifically, experts suspect that a combination of a certain foot type, along with years of abnormal pressure over the big toe joint (called the first metatarsophalangeal joint), is what commonly leads to bunion formation. In particular, wearing shoes that crowd the toes together is a common culprit. This is, in part, why women tend to develop bunions more than men; many women's shoes have narrow toe boxes. High heels can make matters worse by forcing the toes even deeper into the narrowed tip.

Besides narrow footwear and an inherited foot type, other factors that may contribute to bunion formation include:

bunion pain treatment

Verywell / Brianna Gilmartin


The diagnosis of a bunion can be made by physical exam alone, as this bony deformity is visible to the naked eye. That said, to fully access the bunion and big toe joint, your healthcare provider may order an X-ray.


Treatment of a bunion is only required if it is causing symptoms. While there are numerous non-surgical treatment options available, if bunion symptoms are severe or persistent, then surgery to correct the misalignment may be considered.

Self-Care Strategies

When dealing with acute bunion pain, these self-care strategies may give you some relief:

  • Remove your shoes and elevate your feet to relieve some of the pressure and inflammation.
  • Apply an ice pack if the pain and swelling are extreme (aim for several 10- to 15-minute sessions a day). Be sure to move the ice pack around and place a thin towel between the pack and your skin.
  • Soak your feet in cool (not ice) water to reduce swelling. Use a warm foot bath or a moist, steamed towel if you're experiencing big toe joint stiffness.
  • Stretch your feet with a simple set of routine exercises to keep the foot flexible and avoid stiffness.


To ease the pain of a bunion, your healthcare provider may recommend taking an over-the-counter anti-inflammatory medication, like Advil (ibuprofen).

Less commonly, your healthcare provider may inject a steroid (cortisone) into the bursa (the sac surrounding the big toe joint) to relieve inflammation.

Shoe Inserts

If you have a painful bunion, you can relieve some of the pain by either padding the bunion from the outside or forcing the toes into a more natural position.

Bunion pads are readily available at most drugstores and are made either of moleskin, neoprene, foam, silicone, or a gel-filled plastic. They lessen the pressure placed on the bunion while wearing shoes and tend to work best when wearing shoes with a wide toe box. While most bunion pads are applied with a removable adhesive strip, others are woven into the fabric of removal booties.

Toe spacers, as per their name, are placed between your toes. Most are made of contoured foam or plastic. While some only open the space between the big toes, newer, glove-like models are constructed of neoprene and separate all five toes.

Among the variety of bunion relief appliances, there are night splints that can gradually correct the toe alignment and even slip-on inserts that combine a bunion pad with individual toe separators.

Proper Footwear

Even if the shoes you wear have low heels and a square foot box, they may not fit properly. Many foot problems arise simply because of choosing fashion over comfort and support.

While you may think you know your correct size, manufacturer sizes can vary enormously, leaving you swimming in some shoes and barely able to put on others. Moreover, your shoe size can change as you age since the vertical pressure placed on your feet can, over time, cause the bones and cartilage to flatten and spread.

To prevent or correct a foot problem, get your feet correctly measured every five years or so.

A specialty running shoe store is a great place to get your feet measured, as these retailers are likely to conduct a comprehensive foot evaluation. This not only involves the sizing your foot but an assessment of your foot alignment and arch.

The evaluation can give you insight about what type of shoe is best for you, including whether you need custom orthotics or arch supports. The better your shoes fit, the less likely your toes will slip forward and become compressed.

If searching for the right shoe to treat bunion pain, always look for the following features:

  • A toe box large enough to wiggle and spread your toes
  • A heel no higher than one to two inches
  • Malleable shoe material, such as canvas or a soft leather
  • Enough interior space to insert bunion pads or insoles
  • A moderately flexible sole (as opposed to a hard or flimsy sole)

Physical Therapy

Some podiatrists refer their patients to a physical therapist who specializes in treating foot conditions. To ease inflammation and bunion pain, your physical therapist may use ultrasound therapy.


If your bunion pain is severe or persistent and/or diminishing your overall daily functioning/quality of life, it's sensible to discuss surgery with your healthcare provider. The goals of bunion-reducing surgery are to alleviate bunion pain and deformity. Surgery may be done to help realign the toe joint and restore function (hallux valgus surgery).

Depending on various factors like your age, activity level, and the severity of your bunion, your surgeon will choose one of many surgical procedures, including osteotomy (bone realignment), arthrodesis (joint fusion), resectional arthroplasty (removal of the damaged joint), or exostectomy (removal of the bunion bump only). Exostectomy is rarely performed alone; since it does not realign the big toe joint, the bunion often recurs.

If you are uncertain as to whether surgery is right for you, consider asking your foot and ankle surgeon these questions:

  • What are the risks and benefits of the treatment?
  • What results can I expect?
  • What is involved in recovery?
  • How is post-operative pain managed?

These responses, along with the cost of the recommended procedure, can help you make an informed choice.

A Word From Verywell

A bunion, albeit common, can be a frustrating foot condition to deal with. However, with the right self-care strategies and some diligence on your part, most people can manage their bunion(s) well.

That said, if you are not obtaining relief with simple measures or your bunions are affecting your mobility or daily quality of life, be sure to talk with your healthcare provider about next steps. Surgery may be a sensible option for you at this point.

Frequently Asked Questions

  • What causes a bunion?

    Factors that can cause or contribute to bunions include:

    • Wearing narrow footwear
    • Foot injury or trauma
    • Inflammatory arthritis
    • Neuromuscular conditions like cerebral palsy
    • Genetic disorders such as Down syndrome
    • Inherited traits
    • Flat feet or low arches
  • Is there treatment for a bunion?

    Yes. Bunion pain can include elevating bare feet to relieve pressure and inflammation, applying an ice pack wrapped in a towel for 10 to 15 minute intervals, soaking feet in cool water to reduce swelling, and foot stretches.

    Surgery can be done to correct the joint's misalignment, but it is usually only recommended if the bunion disrupts daily life.

  • How can I prevent bunions?

    Not all bunions can be prevented, and they may form due to genetic factors. However, the following options may help reduce the likelihood of developing a bunion.

    • Wear comfortable shoes that fit correctly and have a wide toe box.
    • Avoid high heels.
    • Rest your feet when you can.
  • Are there exercises to treat bunion pain?

    Yes, there are exercises that can relieve bunion pain and strengthen foot muscles. It is thought that weak muscles play a role in bunion pain and movement problems. A healthcare provider may prescribe specific exercises to improve foot muscle strength.

21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Shi GG, Humayun A, Whalen JL, Kitaoka HB. Management of Bunionette Deformity. J Am Acad Orthop Surg. 2018;26(19):e396-e404.

  2. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Bunions: Overview. Available from:

  3. Ferrari J. BunionsBMJ Clin Evid. 2009;2009:1112.

  4. Ellington JK. Hammertoes and clawtoes: proximal interphalangeal joint correction. Foot Ankle Clin. 2011;16(4):547-58.

  5. Al Aboud AM, Badri T. Corns. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from:

  6. Tamer P, Simpson S. Evolutionarily medicine Why do humans get bunions? [published correction appears in Evol Med Public Health. 2017 May 09;2017(1):81]. Evol Med Public Health. 2017;2017(1):48–49. doi:10.1093/emph/eox001

  7. Chou LB. Disorders of the first metatarsophalangeal joint: diagnosis of great-toe pain. Phys Sportsmed. 2000;28(7):32-45.

  8. Kitson K. Bunions: their origin and treatment. J Perioper Pract. 2007;17(7):308-10, 315-6.

  9. Kalen V, Brecher A. Relationship between adolescent bunions and flatfeet. Foot Ankle. 1988;8(6):331-6.

  10. Shirley ED, Demaio M, Bodurtha J. Ehlers-danlos syndrome in orthopaedics: etiology, diagnosis, and treatment implicationsSports Health. 2012;4(5):394–403. doi:10.1177/1941738112452385

  11. Nork SE, Coughlin RR. How to examine a foot and what to do with a bunion. Prim Care. 1996;23(2):281-97.

  12. Ferrari J, Higgins JP, Prior TD. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev. 2004;(1):CD000964.

  13. Hurn SE, Vicenzino BT, Smith MD. Non-surgical treatment of hallux valgus: a current practice survey of Australian podiatristsJ Foot Ankle Res. 2016;9:16. doi:10.1186/s13047-016-0146-5

  14. Grice J, Marsland D, Smith G, Calder J. Efficacy of Foot and Ankle Corticosteroid Injections. Foot Ankle Int. 2017;38(1):8-13.

  15. Tehraninasr A, Saeedi H, Forogh B, Bahramizadeh M, Keyhani MR. Effects of insole with toe-separator and night splint on patients with painful hallux valgus: a comparative study. Prosthet Orthot Int. 2008;32(1):79-83.

  16. Branthwaite H, Chockalingam N, Greenhalgh A. The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy femalesJ Foot Ankle Res. 2013;6:28. doi:10.1186/1757-1146-6-28

  17. Boulton AJ, Armstrong DG, Albert SF, et al. Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical EndocrinologistsDiabetes Care. 2008;31(8):1679–1685. doi:10.2337/dc08-9021

  18. Menz HB. Foot orthoses: how much customisation is necessary?J Foot Ankle Res. 2009;2:23. doi:10.1186/1757-1146-2-23

  19. Mortka K, Lisiński P. Hallux valgus-a case for a physiotherapist or only for a surgeon? Literature review. J Phys Ther Sci. 2015;27(10):3303–3307. doi:10.1589/jpts.27.3303

  20. Meyr AJ, Singh S, Chen O, Ali S. A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgusJ Radiol Case Rep. 2015;9(6):29–43. doi:10.3941/jrcr.v9i6.2142

  21. Bunion: Strengthening foot muscles to reduce pain and improve mobility.  J Orthop Sports Phys Ther. 2016;46(7):606. doi:10.2519/jospt.2016.0504

Additional Reading
  • American Podiatric Medical Association. (2019). Bunions.

  • Dini M. Podiatric Disorders. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Current Medical Diagnosis & Treatment 2019 New York, NY: McGraw-Hill; 

  • Ferrari J (2017). Hallux valgus deformity (bunion). Eiff P, Asplund CA, eds. UpToDate. Waltham, MA: UpToDate Inc.

  • Hern, S.; Vicenzino, B.; and Smith, M. Non-surgical treatment of hallux valgus: a current practice survey of Australian podiatrists. J Foot Ankle Res. 2016;9:16. DOI: 10.1186/s13047-016-0146-5.

  • MacDonald, A.; Houck, J.; and Baumhauer, J. The Road to Recovery for Bunion Surgery. Foot Ankle Orthoped. 2017. DOI: 10.1177/2473011417S000275.

Catherine Moyer

By Catherine Moyer, DPM
Catherine Moyer, DPM, is a podiatrist experienced in the diagnosis, treatment, and prevention of disorders of the foot and ankle.