A bunion (hallux valgus) is a condition that affects the joint at the base of the big toe, causing a bump to grow. Pointed-toe shoes that squeeze the foot such as high heels and cowboy boots can contribute to the development of bunions.

Anatomy
“Hallux” is the medical term for big toe and “valgus” is an anatomic term meaning the deformity goes in a direction away from the midline of the body. With a bunion, the big toe begins to point toward the outside of the foot. After time, the bone just above the big toe, the first metatarsal, develops too much of an angle in the other direction. The bunion that develops is a response to the pressure from the shoe on the point of this angle. At first the bump is made up of irritated, swollen tissue that is constantly caught between the shoe and the bone beneath the skin. After time, the constant pressure may cause the bone to thicken as well, creating an even larger lump to rub against the shoe.
 

Symptoms
A bunion can be painful and the deformity can become a cosmetic problem to many, often making it hard to find appropriate shoe wear. Increasing deformity begins to displace the second toe upward, creating additional rubbing on the shoe.
 

Diagnosis
Diagnosis begins with a careful history and physical examination by your doctor. X-rays will allow your doctor to measure several important angles made by the bones of the feet to help determine the appropriate treatment.
 

Medical Treatment
Treatment of a bunion nearly always starts with adapting the shoes to fit the feet; converting from a pointed-toe shoe to a shoe with a wider toe box can arrest the progression of the deformity. Bunion pads may reduce pressure and rubbing from the shoe. These are also numerous devices, such as toe spacers, that attempt to splint the big toe and reverse the deforming forces.
 

If all conservative measures fail to control the symptoms, then surgery may be suggested. There are well over 100 surgical procedures described to treat hallux valgus. The basic considerations are removing the bunion, realigning the bones that make up the big toe, and balancing the forces so the deformity does not return.