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What Causes a Bunion?

Bunions are more than just a bump; they are actually caused by an unstable joint in the middle of the foot that allows the bone to drift out of alignment. They often do not go away on their own, so while conservative treatments might help keep the symptoms at bay for a bit, bunions worsen over time–and surgery is usually necessary.1 If you think you might have a bunion or are experiencing foot discomfort that could be related to a bunion, it’s best to consult with a foot specialist.

Bunions may cause discomfort, cause pain, and even hinder your ability to walk or stand comfortably. Some telltale signs that indicate you should seek medical attention for a potential bunion issue are:

    • Persistent pain and discomfort in the big toe joint, especially when walking or wearing shoes1
    • Visible bump on the side of the foot (more specifically the big toe), which is the most common symptom1
    • A toe deformity where the big toe deviates towards the smaller toes, causing overcrowding1,2
    • Difficulty wearing shoes (inappropriately fitting shoes exacerbate the pain and symptoms)1,2
    • Redness and swelling around the big toe joint1,2
    • Decreased movement in the big toe1,2
    • A family history of bunions, which puts people at higher risk1,2

It’s important to see a foot specialist who specializes in conditions with the symptoms above and remember that early intervention can help prevent the bunion from worsening (and potentially requiring more invasive treatments in the future)!

What are the most common causes of bunions?

Usually characterized by a bony bump near the big toe joint, bunions occur when that joint becomes misaligned. It’s important to understand why all of the issues listed below may have a hand in forming this progressive deformity so you know the best way to remedy the situation specific to you.

Genetics is one of the most common factors that contribute to bunions. If a close family member had bunions, then you may be more likely to develop them as well; genetic factors influence the shape and structure of your feet, which can make you more likely to have bunions.1,2

Foot mechanics, like flat feet and low arches, can change up the distribution of weight and add structural issues, which may lead to imbalances that cause bunions.2 A previous injury can also lead to changes in foot mechanics or joint alignment, contributing to the development of bunions, and in addition to hormonal changes and specific footwear, women are more susceptible to bunions due to foot mechanics as well.1,2

Joint laxity or hypermobility (when joints are more flexible and prone to shifting out of alignment) can also make certain people more susceptible to developing bunions.3

Inflammatory conditions, such as rheumatoid arthritis, can increase the risk of developing bunions, because these conditions affect the joints and lead to joint deformities (like bunions)!2,3

Age definitely can be a factor when looking at the cause of bunions. While bunions can appear at any age, the older you get, the more common they are.3 Over several years, the buildup of pressure and poor shoe choices can finally take its toll on your feet and may cause painful bunions.

By checking with a surgeon, you can better understand your risks and learn how to manage your bunions–or find out what the next steps are, so you can live a life where bunion pain won’t hold you back any longer.

Can high heels & tight shoes cause bunions?

A common misconception is that high heels and shoes that fit tightly across the toe box are a culprit of bunions. While they both can certainly exacerbate the problem by squeezing the toes together and putting pressure on the big toe joint, they are not the root cause of your bunion. Bunions are a 3D problem that form when an unstable joint in the middle of the foot allows the bone to drift out of alignment, causing the painful bump you see at the base of the big toe.

Are bunions hereditary? Can I be genetically predisposed to bunions?

Hereditary conditions and biomechanical imbalances of the foot’s anatomical structure can cause instability (such as a flat arch, flexible joints, the big toe pointing outward, or excessive inward rolling of the foot), leading to bunions. This means that people are actually born with the tendency to get them (or not). These determinants lead to less stable joints and are more prone to misalignment.3,4

While the potential to develop bunions might be the outcome of an inherited problem with the structure or anatomy of your foot, this is not the only explanation that plays a role in making someone more susceptible to bunions or their progression. Improper footwear, a previous injury, and certain occupations/activities can also greatly contribute to the acceleration of bunions.

Can prior foot injury lead to a bunion?

When the foot experiences an injury, that trauma can sometimes create changes in foot mechanics or joint alignment, ultimately leading to the development of bunions. An injury might change the way you walk or stand and distribute weight on your feet, or it might put extra pressure on your big toe joint, creating imbalances. Injuries can also cause inflammation and swelling in the affected area, which puts pressure on nearby joints and tissues, potentially affecting the alignment of the big toe joint. If this is the case, and the person continues to play sports and participate in high-impact activities, this may only compound the issue.2,3

While injuries play a role in bunion development, there are several other factors that might be causing the issue, such as footwear, foot structure, and overall foot health. Consulting a surgeon is the best way to be evaluated and get guidance on how to proceed.

Are older people at a higher risk of developing a bunion?

If bunions are left untreated, they progress over time.1,2 If an older person has ignored their bunion for many years and has other inflammatory conditions like arthritis, then the joints in their foot structure are at a higher risk of developing bunions too. Over time, the effects of wear and tear such as walking, standing, and wearing shoes that might not fit correctly may lead to changes in foot mechanics and the formation of bunions.2

To minimize the risk of bunions, you can be proactive by wearing supportive shoes that have a wide toe box, keeping a healthy weight, practicing foot-strengthening exercises, consulting with a surgeon who can help keep you on track with taking care of your feet as you age.

What can I do if I think I have a bunion?

It’s important to know how to be proactive in preventing and managing bunions, and it all starts by making choices that reduce the stress and pressure on your feet. This involves wearing proper footwear that fits correctly (a wide toe box is crucial), steering clear of high heels and tight footwear, maintaining a healthy weight, and performing foot exercises that promote strength and flexibility. Remember that there should be space between the tip of your longest toe and the end of the shoe, and your shoes should mold to the shape of your feet without squeezing or pressing any part of your foot!

If you have a family history of bunions or are experiencing foot discomfort, definitely consult with a surgeon so you can receive an accurate diagnosis and professional treatment.

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