A bunion is typically a progressive deformity of the great toe joint causing a large prominence of bone (bunion) on the side of the joint and deviation of the great toe towards the lesser toes – in other words, the bunion is pushing your big toe towards your smaller toes.
Bunion pain is associated with rubbing of the bump in shoes and/or motion of the joint. Soreness may be found under the ball of the foot in the presence or absence of a callus. Occasionally, redness or even a wound can form over the boney prominence. Drifting of the great toe into the lesser toes can contribute to hammertoes and poor alignment of the joint. With longstanding bunion, arthritis can develop and be seen on X-ray as wearing away of the joint. This arthritic process is what causes bunion pain with motion of the great toe.
Although certain poorly fitted shoes may contribute to symptoms and progression of bunion deformity, there is little evidence that shoes in and of themselves cause bunions. There are many examples of indigenous people who have never worn shoes yet experience very severe bunions. Bunions are typically an inherited, family trait that may progress.