In bunion, the joint of the base of the big toe appears to stick out (becomes prominent).
• Abnormalities in joint position or motion can distort and enlarge or seem to enlarge the joint that connects the big toe with the foot.
• Pain and swelling can affect the inner part of the joint or the entire joint.
• Changing shoes, using pads or devices that change the position or range of movement of the foot and relieve pressure on affected joints (orthoses), or a combination of measures usually helps.
A condition that is often part of the bunion is an abnormal position of the big toe or the bone to which it connects. One such condition is an abnormality in which the joint at the base of the big toe bulges outward from the inner side of the foot and the big toe points inward (toward the smaller toes). This is called hallux valgus. Other factors that contribute may include excessive turning in (pronation) of the ankles and occasionally injury. Osteoarthritis may develop, and bone spurs may form. Osteoarthritis may cause joint scarring, limiting the foot's range of motion. The joint may swell. A bursa (a painful swelling of the fluid-filled sac) can develop and become swollen and tender if tight shoes are worn.
Symptoms and Diagnosis
The first symptom may be painless enlargement of the joint or pain at the joint when wearing certain shoes. Later symptoms may include increasing enlargement without pain; a painful, warm, red swelling at the inner aspect of the joint; and swelling and pain all around the joint. Joint motion may be restricted.
Doctors usually base the diagnosis on symptoms and examination findings. If the diagnosis is uncertain, x-rays are taken. If infection is suspected, doctors withdraw and analyze joint fluid. If multiple joints are affected, tests may be done to diagnose arthritis.
Treatment
Mild discomfort may significantly lessen by wearing shoes with a wide toe box. If not, bunion pads purchased in most pharmacies can shield the painful area. Orthoses can also help redistribute and relieve pressure from the affected joint. If these measures are ineffective or if the person is unwilling to wear large, wide shoes and orthoses because they are unattractive, surgery is considered. Sometimes taking nonsteroidal anti-inflammatory drugs (NSAIDs) or injecting a corticosteroid with or without an anesthetic can help relieve pain and swelling. If the joints are stiff, stretching exercises, which occasionally require injection of a local anesthetic to relieve muscle spasm, can help. Sometimes, surgery to release scar tissue and improve alignment is necessary.
Resource: Merck Manual Home Edition