Bunions are frequently thought to be a 'bump' on the bone behind the big toe. While this is sometimes correct, most of the time a bunion involves a misalignment of the entire 1st metatarsal bone which shifts out of position because of the way we walk. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. There are also different types of arthritis that can cause the formation of a bunion deformity. In most cases it is a good idea to try conservative care first when treating a painful bunion. Initially, a functional orthotic may be tried to correct the biomechanics of your foot function which will slow the growth of the bunion. Wider shoes, gel bunion pads and anything that reduces the pressure on the bunion deformity can sometimes eliminate the pain and make surgery unnecessary. A cortisone injection or oral NSAID medication may be tried as well. Surgery by a podiatric physician is frequently recommended to correct the problem when conservative care fails to alleviate the pain. There are many different types of bunion surgery that can be utilized to address your needs and Dr Resler will review all your options with you during your consultation.