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Q & A


Bunions form when the normal balance of forces that is exerted on the joints and tendons of the foot becomes disrupted. This disruption can lead to instability in the joint and cause the deformity. Bunions are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk and our inherited foot type or our shoes.

Other causes include: 

  • Genetic inheritance- problematic foot types  that cause abnormal foot function can be passed down in families and lead to the progression of a bunion deformity 

  • Foot injuries 

  • Neuromuscular disorders

  • Congenital deformities 

  • Tight shoegear



You may be suffering from a painful bunion deformity if you have these symptoms: 

  • Development of a callus or firm bump on the outside edge of the foot, at the base of the big toe

  • Redness, swelling, or pain at or near the MTP joint

  • Development of hammertoes or calluses under the ball of the foot

  • Corns or other irritations caused by the overlap of the first and second toes

  • Restricted or painful motion of the big toe

Home Care

  • Apply a commercial, non-medicated bunion pad around the bony prominence

  • Apply a spacer between the big toe and second digit

  • Wear shoes with a wide and deep toe box

  • If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling

  • Avoid high-heeled shoes 


When should you visit a podiatrist? 

If pain persists, podiatric medical attention should be sought. Dr. Tien is the leading foot and ankle specialist in Orange County and is ready to provide surgical and non-surgical consultations for your bunion pain. Bunions tend to get larger and more painful if left untreated, making non-surgical treatment less of an option.


Treatment options vary with the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery. The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity.

Dr. Tien may recommend these non-surgical treatments at first:

  • Padding and Taping

  • Oral Medication

  • Cortisone injections 

  • Physical Therapy

  • Orthotics 

  • Shoegear modification 


Surgical treatment of bunion deformities are reserved for those that have failed  non-surgical early treatments or the bunion progresses past the threshold for such options. Bunion surgery is not recommended for cosmesis. The goal of bunion surgery is to restore the normal alignment of the toe joint, relieve pain, and improve function of the foot.


There are some steps that may help prevent, or at least slow, the progression of bunions:

  • Avoid shoes with a narrow toe box

  • If your foot flattens excessively, make sure you wear supportive shoes, and if necessary, get custom orthotics from your podiatrist

  • See Dr. Tien at the first signs or symptoms of a bunion deformity, as early treatment may stop or slow its progression


What is a Bunion? 

A bunion is commonly referred to as a “bump”that is a protrusion of the bone on the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone that forms the big toe joint moves out of place or the tissue becomes inflamed causing a bursa.   It is also known as a “hallux valgus” deformity. The term bunion is derived from the Latin word “bunio," meaning enlargement. It can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor's bunion."

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