Bunions 101:

What is a bunion? What can cause a bunion?

A classic bunion occurs at the base of the big toe and can be quite annoying and debilitating. A bunion can be observed when the big toe moves out of its ideal alignment, tipping inwards towards the other toes, and creates what appears to be an extra "bump" at the base of the big toe. This alignment is know as hallux valgus. A bunion may be accompanied by pain, inflammation, and limited motion (hallux rigidus). Bunions may occur in one or both feet depending on the person and what has caused the bunion. They can make standing, walking, and running painful. For some, it will even make wearing shoes uncomfortable once the bunion is big enough to cause pressure and friction inside the shoe.

If your parents have bunions, you may feel inclined assign some blame in their direction. There may be some validity to that assumption for some bunions, but it's certainly not the whole story. While bone structure is certainly something that you inherit from your parents, you also need to consider what your feet have been put through that may trigger and be contributing to the process.

There appears to be at least of couple foot postures that make someone more prone to developing bunions (see 2 images below).

What is typically mentioned is having flat feet, or excessive pronation (see image above). If you constantly have more weight on the inside of your foot, this puts a lot of pressure on the inner edge of your big toe and is likely to get chronically pushed out of alignment towards the other toes.

Another example occurs when the bone at the base of your toe (metatarsal) shifts away from the others and the big toe collapses inwards (see image at top of page). The later often results in a bunion that appears to have a large bump that looks like extra bone growth, even though it is not. The bump is just the bone in your foot at the base of your toe shifting way from your toes causing the end of that bone to be exposed where the big toe normally located.

I should note that both of these foot postures are very different in regards foot function and how the rest of the body will move. Both are a problem with managing weight distribution in your feet, but the reasons for having the extra weight and and how the pressure travels into your big toe are different. Different problems require different solutions, so not all devices, products, stretches, and exercises for bunions are good for every bunion. The best way to take pressure off of a bunion is to learn how to walk with less of this repetitive pressure pushing on your big toe.

There are certainly devices that can help with fix or relieve pain from a bunion, but I will discuss those in another article and discuss a few thing that can be done to prevent bunions and avoid placing undue stress at the big toe.

Shoes seem like a good place to start since so many of us spend so much time in them at work, for exercise, and perhaps even at home. Many modern shoes (both athletic, casual, and dress) are constructed with a narrow toe box. Some people can wear these shoes for their whole life without developing a bunion, but if you are already prone to having a bunion or see one developing, consider this a BIG SHOVE in a BAD DIRECTION. Generally the earlier a bunion starts in life, the worse it can potentially get, so it is best to just remove bad footwear from the equation. Women's footwear with pointed toes and elevated heals create an ideal situation for a bunion to form.

Another thing to consider if you have a bunion is what other types of aches, pains, and injuries has you body been through.

  • If you have a bunion on your left foot, did you may recall an old injury to your left knee or you may note that "all my problems happen to my left side." When we have an injury, our body looks for ways to adapt and sometimes our big toe suffers in order to deal with another problem. Your posture and changes in your movement after an injury can certainly influence your bunions. Knee and hip injuries are a common thing I see related to bunions.

  • If you happen to have bunions on both feet, it is very likely that you also experience hips, back, and neck that are stiff and achy. If your head is held forward or you have trouble standing upright, your posture can certainly influence your bunions.

As with any ache, pain, or injury it is very important to consider why a problem, like a bunion, has developed. The more you understand about why it happened in the first place, the better your chances are at succeeding at whatever you end up trying to solve it. There are several products on the market available that are meant for bunions, but not all of them will help every bunion. A bunion is not just a bunion. The big toe is one part of a complex system and may not respond well to the same thing that worked for someone else.

In my next article, I will continue this discussion with some products, footwear, and things that I commonly see in patients who happen to have bunions. Stay tuned!