Bunions

Treatment Overview

A bunion (hallux valgus) is an enlargement of bone or tissue around the joint at the base of the big toe (metatarsophalangeal jointClick here to see an illustration.). A bunion causes a bump on your big toe joint. The big toe may turn toward the second toe (displacementClick here to see an illustration.), and the tissues surrounding the joint may be swollen and tender.

If you have a bunion but do not have pain or discomfort, treatment may not be necessary. The goals of treatment for bunions are both to relieve toe pain so that it does not limit daily activities and to prevent the bunion from getting worse.

Most bunions can be treated at home. In some cases, surgery is considered.

Nonsurgical treatment

Nonsurgical treatment usually is used to decrease pressure on the big toe and relieve pain. Treatment includes:

  • Wearing roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint. For more information, see:
    Click here to view an Actionset.Foot problems: Finding the right shoes.
  • Using bunion pads, arch supports, or custom-made supports (orthotics) placed just behind the big toe joint on the bottom of your foot. They can help redistribute your weight while you are walking and take pressure off your big toe. Ask your health professional to help you choose the right kind of pads.
  • Using moleskin or felt patches over or around pressure areas, to protect the bunion from being rubbed by your shoes.
  • Taking nonprescription medicine to relieve pain and reduce swelling. Examples include acetaminophen (such as Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin. If you have other health conditions, such as diabetes, peripheral arterial disease, or gastrointestinal problems such as gastritis or gastroesophageal reflux disease (GERD), talk to your doctor about which pain reliever is best for you.
  • Using ice to relieve pain and reduce swelling. Apply ice to the joint for 10 to 20 minutes at a time, 3 or more times a day as needed. Elevate your foot so that your toe is higher than your heart.

Physical therapy, splints, or braces have not been proved to successfully treat bunions. But these treatments may be helpful for some people.

Surgical treatment

If nonsurgical treatment has not relieved toe pain and you aren't able to do normal daily activities, or if you have a severe bunion, you may want to consider surgical treatment. Bunion surgery is done to help restore normal alignment to the toe joint and relieve pain. For information on making the decision about surgery, see:

Click here to view a Decision Point.Should I have surgery for bunions?

There are different types of bunion surgery—the best type of surgery for you depends on how severe your bunion is and how experienced your surgeon is. Look for a surgeon who does many different types of bunion surgery on a regular basis. Each bunion is different, and surgery needs to be tailored to each case.


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Author: Shannon Erstad, MBA/MPHLast Updated: March 6, 2008
Medical Review: William M. Green, MD - Emergency Medicine
Gavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery

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