What Causes a Bunion?

Sep 28, 2020

You can’t really pinpoint the exact moment when your bunion began.

Sure, you might remember when you first noticed something amiss with the joint at the base of your big toe. But your bunion certainly began before that. And in many stories, that initial inkling of trouble was put off or ignored until later, when the bunion became too large and obtrusive to ignore.

A bunion takes time to develop – a lot of time, in most cases. Within those years, a number of different factors may be involved in making your bunion progressively worse.

Whether your bunion is in its earliest stages or already advanced, knowing and addressing the causes behind it can be a valuable tool to relieve discomfort and prevent the joint from becoming even more deformed. In some cases, it can even mean the difference between effective conservative management and the need for surgery.

Starting at the Foundation

At its core, a bunion is caused by an imbalance of forces in the metatarsophalangeal (MTP) joint—the one at the base of your big toe, where the bunion bump forms.

A joint is where two bones meet, but joints that move are also surrounded by tendons, ligaments, muscles, and other soft tissues that help direct that motion and provide further stability. If anything upsets the balance between these structures, the joint can shift out of alignment over time.

What causes this imbalance, however?

In many cases, it is believed that the joint instability is a matter of inheritance. In other words, you were born with a naturally higher likelihood of developing a bunion.

Take a look through your family. If bunions are common among your parents, grandparents, and other blood-related family members, your chances of having a bunion are likely significant.

That said, having no history of bunions in your family does not mean your chances of developing one are zero. Other factors besides heredity can have an impact in destabilizing the joint, including:

  • Having an inflammatory joint condition, such as rheumatoid arthritis
  • Having a neuromuscular condition
  • Experiencing past trauma to the joint

But What About Shoes?

Certain types of shoes are very often blamed for bunions, and they certainly aren’t completely innocent in the matter. But whether they are at the root cause of bunions is a topic of some debate.

What we do know for sure, however, is this: While improper footwear might not be the source of a bunion, they can absolutely make an existing bunion problem worse.

What are improper shoes when you have a bunion? Any footwear that:

  • Has a high heel, shifting more weight toward the front of the foot.
  • Has a narrow and/or small toe box, forcing the toes to be compressed together.

High heels tend to fit both these categories, and usually get the most criticism – likely because bunions are much more common in women. However, any form of shoe with the above qualities, including men’s dress shoes, can cause a problem.

When there may already be an existing weakness in a structure, such as your toe joint, the application of excess forces like this can cause further trouble over time. You wouldn’t lean against a loose railing, after all.

A Plan for Bunion Treatment and Prevention

The more we understand about the causes and influences behind your bunion, the more effective a plan we can recommend to manage your symptoms.

Our goals for bunion treatment are always to relieve pain and other symptoms as best as possible, as well as to slow or prevent further progression of the bunion. In many cases – even for many long-standing bunions – these goals can be achieved via conservative treatments like custom orthotics, conditioning stretches and exercises, night splints, and other methods.

If these measures are not (or clearly would not be) successful, we may consider a surgical procedure to provide relief and sustained mobility. Once again, knowing the causes and factors behind your bunion aids us in recommending the path to yield the best results.

Whether you believe a bunion is just starting to develop or you have lived with one for a long time, do not delay any longer in receiving the care you deserve. Call our Spring Valley office at (845) 352-7507 or fill out our online contact form to schedule an appointment.

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