A bunion is a famous foot condition commonly thought to be a condition of old age. In truth, a bunion is a common foot deformity that can be present in adult as well as children's feet. Bunions form when there is instability of the inner part of the foot that leads to a gradual movement of the long bone at the base of the big toe (called the 1st metatarsal) towards the skin. In addition to the 'bump' created by the outward moving bone, the big toe moves in the other direction tilting towards the 2nd toe. This deformity often develops slowly over time, and can become painful anywhere from just before one's twenties to their sixties. However, some children develop bunions from a very early age, and can have pain before the teen years.
Bunions are primarily painful when narrow or shallow shoes rub constantly on the bump throughout the day. Bunions can hurt from skin irritation on the bump, as well as deeper irritation that makes the side of the joint and overlying nerve tissue inflamed. The skin over the top of the bunion can become red and swollen, or it can simply hurt without any external symptoms. Over time, as the big toe joint moves in this abnormal position, arthritis can form. When this happens, the joint can hurt with simply moving it, and spurs can develop on top of the joint. As this deformity worsens, the motion of the joint can decrease, furthering the pain.
Bunion treatment is usually successful, but most of the time requires surgery to correct the abnormal bone position. Non-surgical bunion treatment like wider shoes, inserts in the shoes to control the instability leading to worsening of the bunion, and medication to reduce the inflammation can help temporarily, but often the pain easily returns since the deformity remains. With surgery, the bone is gently moved back over into the proper position, and set there until it heals. Bunion surgery has high success in most patients, and relieves most if not all of the pain while restoring normal function to the toe.