An abnormal prominence on the inner aspect of the first metatarsal head, with bursal formation, and resulting in lateral or valgus displacement of the great toe. Bunions can be caused by congenital malformation of the bony structure of the foot or by joint disease such as rheumatoid arthritis and are aggravated by wearing high-heeled shoes with pointed toes. When the shoes do not fit properly they force the great toe toward the outer side of the foot. The result is continued pressure on the joint where the great toe articulates with the first metatarsal head. Chronic irritation causes a build-up of soft tissue and underlying bone in the area. Symptoms are swelling, redness, and pain. Mild cases can be relieved by changing to properly fitting shoes. If there is severe pain making ambulation difficult or impossible, anti-inflammatory agents may be effective. Surgical correction (bunionectomy) is indicated when all other measures fail.