Bunions on Feet

What Causes Bunions, Bunion Treatment, Shoes for Bunions, and more

What Causes Bunions?

Understanding what causes bunions will be easier if we first address a different question:


The unsightly bump you can see and feel on the side of your foot at the base of your big toe or little toe is commonly referred to as a bunion. But a bunion is really more than what you see. The bump you can see is there because of something you cannot see… extra bone at the base of the big toe joint inside your foot.

Normally, the long bones in the foot (the metatarsal bones) line up with the bones in the toes. In the beginning stages of the development of this foot disorder, the big toe begins to lean over to the second toe. This is something you will clearly notice when you have your shoes off.

Eventually, as the big toe leans over, it pushes the first metatarsal bone in the foot outward.  Then the bone in the foot is no longer aligned with the bone in the big toe as it is supposed to be.

Often when this happens, a large knot – or bump – of extra bone forms on the head of the metatarsal bone, intensifying the problem.
"big toe bunion diagram"
As the metatarsal bone with its bump of extra bone protrudes outward, it creates an enlarged area or bump on the outside of your foot. This bump you can see is we call a bunion. However, as you can see from the diagram, it is there only because of what has happened inside your foot.


HEREDITY The relationship between bunions and heredity  has been controversial in the past, but there now seems to be more clarity  on this issue. The general consensus now in the medical profession is that, while bunions themselves are not hereditary, a certain kind of bone structure in a person’s feet increases their likelihood of developing this foot deformity.  Also, the presence of ligaments that are unusually flexible is another inherited trait that has been connected to the development of bunions at some point in a person’s life. In both of these situations, the degree of pressure the forefoot and toes receive from tight shoes or from lifestyle choices or occupations aggravate the inherited conditions and increase the likelihood of bunions on the feet.

Another particular genetic predisposition is flat feet. Almost all babies are born with flat feet, but most naturally develop arches as they grow into childhood. If your arches did not develop adequately, then you are at risk for having foot problems throughout your life. Early intervention during childhood of flat feet and other abnormal foot conditions can reduce the later occurrence of bunions and other painful health problems.

ARTHRITIS  Many people assume that getting older is a major risk factor for getting bunions, but the relationship between these two issues is not so direct. This painful foot problem is indeed associated with the elderly, but that is because bunions can be a by-product of osteoarthritis, the most common form of arthritis.  Osteoarthritis is most common in females who are over the age of 50, so you see that getting older is a risk factor getting osteoarthritis. If the arthritis affects the joint of the big toe, then a foot bunion can develop.  But it is not correct that advancing age  only by itself results in the growth of these unsightly bumps on the side of a person’s feet.  Don’t assume that your grandmother will get bunions as she ages only because she’s getting older.  But if she has osteoarthritis in her feet, then that’s a different story. Indeed, anyone of any age who has osteoarthritis in the feet suffers an increased risk for this foot problem.

Bunions can also be one of the many by-products of rheumatoid arthritis, a degenerative disease which breaks down the the tissues surrounding the joints in the body, usually beginning with the small joints in the hands and feet.  Like osteoarthritis, rheumatoid arthritis also affects primarily females (three times more females than males), but this type of arthritis unfortunately is associated with a wider age group than osteoarthritis.  The onset of rheumatoid arthritis can be as early as 30 years of age, or even younger.  As this painful disease, for which there is no known cure, breaks down the tissues surrounding of the joints in the foot, various foot deformities, such as bunions and hammertoes, often occur, along with resulting foot pain. Visit this link from the Arthritis Foundation for more discussion on arthritis and foot care: http://www.arthritis.org/foot-care.php

SHOES Whatever your genetic predisposition, many doctors believe that the type of shoes you wear is the most important factor in determining the overall health of your feet. It’s very likely you are a woman if you are reading this, because women suffer ten times more from bunions than men do. Does that give you an idea of the primary factor in the development of this foot problem? Shoes, ladies…it’s the shoes!

Shoes that are too tight but that we can’t resist wearing anyway because they go so perfectly with a favorite outfit, or shoes our feet were just not designed to fit into…such as high heels….are the main reason for the development of bunions and other foot problems. It would be really great if we could change our perception and attitudes about what is makes an attractive shoes, but personally I’m not holding my breath on this score.

The fact is you may have inherited the type of abnormal bone structure in your feet that makes bunions more likely than not, but you could go your whole life without even knowing it or without any kind of foot problem at all.  But, if you frequently cram your feet into tight shoes, you are likely to know it soon enough, because those tight shoes are like an open invitation for these unsightly, painful bumps to develop.

Therefore, your grandmother, who may have worn comfortable shoes most of her life that give her feet plenty of room, may escape having bunions, while you in your 20s or 30s may not. Ladies, no matter how elegant or sexy they are, it’s just a fact that shoes with pointed toes, especially high heels with pointed toes are bad news for your feet. Boots with heels are another type of shoe that can cause foot problems, so in the winter you have to be careful with this kind of footwear.  Think about how high heels and boots are designed. They both have a sloping foot bed and a narrow toe box. The toes get squeezed together because the slope causes the front of the foot to be pushed hard into the narrow toe box. There’s just no way this kind of footwear can be good for your feet. If you can’t resist wearing pointed shoes, high heels or boots with heels, please consider yourself forewarned. At least, cut back on how often you “indulge” in this kind of footwear. You will be doing your feet – and yourself- a favor!  If you could look ahead to the possibly of foot surgery and the lengthy time it sometimes takes to recover from that, you might realize that high heels with pointed toes are just not worth it.

LIFESTYLE / OCCUPATIONS Actually, any kind of unnatural pressure on the foot that lasts over an extended period of time can result in a bunion. This means that although shoes that are damaging to your feet are the main non-genetic cause of bunions, anyone with an occupation or lifestyle that requires constant pressure on the feet may be prone to this kind of foot problem. If your job requires that you stand for long periods of time, then you may be a greater risk.  By the same token, dancers and athletes are particularly vulnerable. Actually, dancers and athletes are vulnerable to all kinds of foot disorders, and need to be constantly alert to onset of any such problems. As with any health issue, the sooner it is noticed and addressed, the better.


To recap, bunions are an indication of abnormal bone formation around the big toe joint. You may be born with the type of bone structure which will predispose you to developing bunions. If so, excessive pressure on your feet over time, most often from shoes that are too tight, aggravates this condition.  Occupations requiring extended periods of standing or which place unusual stress on the ligaments and tendons in your feet, such as ballet dancing or athletics, can result in the development of bunions.  The two major forms of arthritis discussed above also put a person at high risk for this serious foot problem.

Hopefully, this article has answered your questions about the cause of bunions and how you can reduce your risk of getting this painful foot disorder.

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