Written by Steven Chen, DPM

A Bunion, medically known as hallux abducto valgus, is an orthopedic structural deformity that causes the bone behind the big toe to protrude. There are several causes for a Bunion deformity; the most common cause is over-pronation of the foot. The foot rolling inward weakens the ligaments and muscles causing the 1st metatarsal to shift, creating an over-growth bony deformity on the medial side of foot. Other factors that can lead to the formation of Bunions include trauma, having flat feet, wearing high heel shoes, as well as some hereditary factors. 

A Bunionette, or Tailor’s Bunion, is a smaller deformity on the outside of the foot associated with the little toe. It can be painful, similar to the Bunion deformity, especially if it rubs against the side of the shoe and limits range of motion at the joint site.   

Both deformities can begin with symptoms of redness, pain, swelling, and even blisters. If left untreated or not managed properly, these deformities can lead to: limited range of motion in the affected joint and arthritis; increased pain in the area; and skin breakdown leading to the need for wound care. 
Individuals with medical conditions such as diabetes and poor circulation can easily get bone infections from a Bunion or Bunionette, which would require long-term IV antibiotic treatment to heal the wound. If the bone becomes too infected, it could lead to gangrene and the possible need for an amputation.   
There are several conservative treatments and management options for a Bunion as well as a Bunionette: 

• These can range from ice and elevation of the affected area to a short course of anti-inflammatory medications to alleviate inflammation in joint.
• Also, various padding can be used around the area to help alleviate the irritation.
• Orthotics can also help limit the excessive pronation of the feet to aid in reducing and preventing the progression of a Bunion and Bunionette.
• Appropriate footwear, such wider-fitting shoes, can also relieve some of the pain caused by a Bunion deformity.

But when a Bunion or Bunionette does not respond to conservative treatment, your Podiatrist may recommend surgery to correct them. The surgery would remove the prominent, irritating bone deformity and correct any misalignment of the joint involved in order to restore proper toe function.