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Todd Borenstein MD

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Bunions (Hallux Valgus)

What is a bunion?

Bunions are a common foot condition. They are abnormal bumps of bone on the inside of the foot by the big toe joint. They can be painless or can become painful, especially with shoe wear. The big toe may also drift towards the second toe and create painful rubbing.

What causes a bunion?

A bunion can be inherited or may develop over time. When bunions develop over time, they are often the result of an imbalance between tendons that leads to joint instability and allow for the bones to move, creating the hard bump of bone on the foot. Bunions can also be the result of tight fitting shoes with a narrow toe box, abnormal walking habits, arthritis of the big toe joint, and loose ligaments.

What are the symptoms of a bunion?

Bunions can cause pain with walking and wearing shoes. The bump of bone can become red and swollen and a callus might develop. There may also be painful rubbing between the big toe and second toe.

How is a bunion diagnosed?

The diagnosis of a bunion begins with a thorough history and physical examination. X-rays will be ordered to determine the severity of the bunion as well as assess for arthritis.

How is a bunion treated?

Nonsurgical treatment

Mild bunions can be treated conservatively by changing shoes, using orthotics to restore the foot to a normal position, physical therapy, and anti-inflammatory pain medication.


In severe cases, and when conservative therapy fails, surgery may be recommended. There are multiple surgical procedures used to treat bunions. Generally, these surgeries entail realigning the big toe joint and removing the bony bump. This is achieved by shortening and lengthening soft tissues, shaving off the bump of bone, cutting bones to straighten the toe, and sometimes fusing to bones together. Your surgeon will discuss with you the options and help you select the most appropriate procedure based on your individual condition and X-rays.