Bunions | Diagnosis & Treatments

How does a doctor know my child has a bunion?

An evaluation should be performed by a pediatric orthopedic surgeon. The surgeon will want to take a medical history and will perform a very careful physical examination. This will involve observing your child's

  • foot alignment
  • weight-bearing alignment
  • walking alignment
  • mobility of the affected joint

The surgeon will also want to know what kind of shoes your child wears and what types of shoes most aggravate the symptoms. He or she will try to determine whether any pain caused by the bunion is due to specific activities and whether the bunion is causing any functional limitations.

X-ray imaging may be used to help determine the extent of the damage and deformity of the toe joint.

What are the treatment options for bunions?

Shopping for Shoes

Bunions, particularly those that affect teenagers, are most often managed by switching to shoes that fit properly and don't compress the toes. Your child's orthopedic surgeon can give you information about proper shoe fit and the types of shoes that would work best for you. The following are some general rules to follow when selecting shoes for your teenager:

  • Judge the shoe by how it fits on your child's foot, not based on the size of the shoe. Sizes vary among shoes styles and brands.
  • Select a shoe that conforms as nearly as possible to the shape of your child's foot.
  • Have your child's foot measured regularly and have both feet measured. The shoe you choose should fit the largest foot.
  • Have your child stand during the fitting process and check that there is adequate space (about 3/8 of an inch) for the longest toe at the end of each shoe.
  • Make sure the ball of your child's foot fits well into the widest part (ball pocket) of the shoe.
  • Do not purchase shoes that feel too tight, expecting that they will stretch over time to fit.
  • Your child's heel should fit comfortably in the shoe with a minimum amount of slippage.
  • Walk in the shoe to make sure it fits and feels right.

Stretching the areas that put pressure on your child's toes can modify some shoes. Your child's orthopedic surgeon may recommend splints to reposition the big toe and orthotics (special shoe inserts shaped to your feet) to help relieve pain.

Your child should wear these shoes at all times, or else risk the bunions coming back.

Source: American Academy of Orthopaedic Surgeons


Surgery is not recommended for teenagers with bunions unless your child experiences sever foot pain that limits everyday activities, and if that pain won't subside with non-operative measures, such as shoe modification and the use of an orthotic.

Surgery for cosmetic reasons alone is not recommended.

There are a number of different types of surgical procedures used to treat bunions. All of the following more common procedures are aimed at relieving pain and correcting the deformity:

  • Osteotomy — the surgical cutting and realigning of the joint
  • Repair of tendons and ligaments surrounding the big toe — These tendons and ligaments may be tight on one side and loose on the other, creating an imbalance that pulls the big toe toward the others. The procedure to correct this is aimed at shortening the loose tissues and straightening the tight tissues. It is often combined with an osteotomy.
  • Exostectomy — Removal of the bump on the toe joint; used only for an enlargement of the bone with no drifting of the big toe.