A bunion is a deformity of the big toe. People with a bunion have a toe that points inward towards the lesser toes, as well as a bump on the inner side of the foot. As the bunion becomes more prominent, pain can develop.

Causes

Bunions are a common problem that can cause foot pain, and difficulty wearing shoes. Occurring in about 30 percent of the population of most Western countries, they are seen most in women, and become more common as people get older.

Blame Your Parents

Genetics do play a significant role, and people who have bunions in the family, are also much more likely to have bunions, than people who do not. The shape and structure of your feet, are probably the biggest culprits for an increased risk of developing a bunion. You have no control over that, since it’s inherited, and you don’t get to choose your parents.

In one study, 83 percent of people with bunions, had a family history of them. A similar number, had bunions on both feet, which points to a cause being the shape, and function of their feet, increasing their risk.

Blame Your Shoes

Tight-fitting shoes are thought to be the cause of bunions in most patients. Shoes such as high heels, or pointy tips, are particularly damaging to the toes. These shoes have a sloping footbed, and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box, causing the toes to become squeezed together.

Depending on factors such as duration of wearing constraining footwear, skeletal maturity, and individual predispositions, the toes can become adapted to the new position. This leads to the deformity we know as a bunion.

Injuries and Inflammatory Conditions

Apart from footwear, injuries to the foot can also be a factor in developing a bunion. People who have rheumatoid arthritis are more prone too, as well as those with neuromuscular conditions, such as polio.

Contributing Factors

Many people who have a bunion, tend to have a combination of factors, that make them susceptible to having it. For example, women forty years and over, with a family history of bunions, who often wear high-heeled shoes, would be considered likely to develop one.

How Much Does Footwear Affect the Development of Bunions?

It’s difficult to know exactly how important footwear is in the development of bunions; but we know it’s the only variable we can significantly control. Bunions are much less common in countries without Western footwear.

They occur in non-Western countries in about three percent of the population. However,  countries with Western footwear, the prevalence is over 30 percent

Bunion Pain

Patients generally have one of two problems that can cause pain:

• Pain over the bunion: As the big toe becomes more and more angled (pointing toward the other toes), the base of the toe becomes more and more prominent, forming the bunion. It forms partly because of the new angle of the toe, and also inflammation over the bunion surface. As the inflammation worsens, people can experience pain with shoe wear, and when walking.
• Development of a hammer toe: The big toe may eventually come to lie over, or more commonly under, the second toe. This may cause further irritation while wearing shoes, and more pain. The second toe of patients who have bunions commonly forms a hammer toe.

 Non-Surgical Bunion Treatments

Bunion treatment should always start with changing footwear to relieve symptoms, and to prevent the bunion from progressing. Shoes with a wide toe box, rather than pointed, minimal slope, and good arch support, can help relieve the pain. Orthotics and padded bunion shields can also help.

Bunion Surgery

When bunions cause pain and inflammation, and simple treatment is not effective, a surgical procedure may be recommended. The aim of surgery, is to realign the broken bone, and  the return of the bunion. Removing the bunion only, without addressing the alignment of the bones of the forefoot, will generally lead to a poor long term result. In these situations, the bunion is likely to recur, as the underlying problem of forefoot mal-alignment, is not addressed.

Are you affected? Seek advice from an orthopaedic surgeon, or podiatrist, regarding your footwear, and more importantly, your bunions.

                    Your feet mirror your general health . . . cherish them!