Why bunions are formed

You may need to wear a short cast and use crutches. Cuts away the bony excess at the head of the metatarsal bone. Removes a wedge-like piece of bone and realigns the metatarsal, which is secured with screws or pins. Corrects tendons and ligaments. Recovery takes 6—12 weeks. If the joint is beyond repair, it may be replaced with an artificial joint.

Variations among toe-joint deformities and surgical techniques make it difficult to evaluate the results of bunion surgery. The problem may be unrealistic expectations. Some patients mistakenly believe that after surgery, the big toe will be completely straight and the foot will fit into narrower shoes. James P. Ioli, chief of podiatry at Brigham and Women's Hospital in Boston. Patients may also expect faster relief from pain and swelling than the procedure allows.

This can happen when only the bony prominence is shaved off and the underlying deformity is not corrected. Sometimes the cut bone reunites too slowly or, rarely, doesn't come together at all. This condition, called nonunion, usually requires another surgery. Other possible complications are irritation from the pins or screws used to hold the bone together and excessive scarring or stiffness.

Swelling after surgery usually eases within two months but may last six months or longer. The joint may be stiff for several months. Nerve damage and continued pain are rare, but when they occur, they can lengthen recovery time and create a need for further surgery. The decision to undergo surgery isn't easy. You'll need to weigh the potential benefits against the risks.

The good news is that bunion surgery isn't a medical crisis. You have time to investigate, weigh your options, and, if you wish, secure a second opinion. Ioli, chief of podiatry at Boston's Brigham and Women's Hospital and assistant professor of orthopaedic surgery at Harvard Medical School, helped prepare this article. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Is a common pain reliever safe during pregnancy? Can vaping help you quit smoking? Print This Page Click to Print. Free Healthbeat Signup Get the latest in health news delivered to your inbox! When the big toe pushes up against the next toe, the metatarsal bone is pushed outward awkwardly. The base of the big toe can enlarge and protrude as a result of the altered motion.

The metatarsophalangeal joint supports the bulk of body weight while walking or standing, and it, therefore, experiences immense wear and tear over a lifespan. This stress and pressure can cause the big toe to move abnormally and misalign at its base. This pressure eventually forms a bunion.

As the bunion progresses, the big toe angles toward the second toe, which creates irritation and inflammation in both toes.

A bunion progressively develops and can become more severe over time. The first metatarsal will keep shifting outward, causing symptoms to increase in severity. The joint becomes unstable, the ligaments are unable to hold the first metatarsal in place, and it drifts outward and away from the second metatarsal. The bunion bump then rubs against the ground and the insides of shoes, stimulating the bone continuously.

The bone responds by growing extra spurs and exacerbating the protrusion. That is one reason why women get bunions more often than men because their shoes tend to be tighter and narrower, thereby forcing the toes against each other. Mild cases of bunions may not show any visual or physical symptoms. In intermediate and severe cases, along with the bony prominence is also an angular deformity where the first metatarsal shifts and increases the normal angle.

Progression differs with different people, but bunions usually develop equally on both feet. Over time, the bone becomes bruised and inflamed, forming painful cysts. Severe bunions may cause premature arthritis and deep pain in the affected joints. A timely diagnosis and conservative treatment may slow the progression of a bunion and avoid chronic, progressive pain and joint damage. It may also eliminate the need for surgery. The human foot is a complex mechanism. Bunions develop when the balance of force exerted on foot tendons and joints changes, causing deformation in the foot structures and imbalance in the joint.

Foot symptoms and possible causes Foot symptoms Possible cause Red, hot, swollen skin over the affected joint that comes and goes Gout Aching, swollen and stiff joints; usually worse in the morning Arthritis Pain, bruising and swelling after hurting your toe Broken toe.

Do wear wide shoes with a low heel and soft sole hold an ice pack or a bag of frozen peas wrapped in a tea towel to the bunion for up to 5 minutes at a time try bunion pads soft pads you put in shoes to stop them rubbing on a bunion — you can buy these from pharmacies take paracetamol or ibuprofen try to lose weight if you're overweight.

Non-urgent advice: See a GP if:. Find a podiatrist. The main operation for bunions is an osteotomy. This involves: Making a small cut in the skin over your big toe. Cutting or scraping away the bunion.