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A bunion is an enlargement of the tissue and bone around the joint at the base of the big toe. As this progresses over time, it forces the big toe toward the second toe. Some causes are: inefficient foot biomechanics like excessive pronation, "bad" shoes, genetic inheritance etc. (A Tailor's Bunion is similar, but at the base of the little toe.) It is often quite painful, with redness and swelling. Other medical conditions need to be ruled out, such as gout, rheumatoid arthritis, infection among others. Treatment is always conservative initially: supportive shoes, pads, orthotics, etc. Physical therapy may be of help to provide relief and maintain/retrain muscles. The last resort is always surgery, done by an orthopedic surgeon or a podiatrist (DPM).