What is a Bunion?

By peter hutch

The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe. The normal position of the big toe (straight forward) becomes outward-directed toward the smaller toes. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis) leading to additional swelling, redness, and pain.

Bunions are often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. With a bunion, the big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion’s “bump.”

Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, never force your foot into a shoe that doesn’t fit. Choose shoes that conform to the shape of your feet. Go for shoes with wide insteps, broad toes and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 1/4 inches. If you already have a bunion, wear shoes that are roomy enough to not put pressure on it. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You may also try protective pads to cushion the painful area.

Bunions are caused by a biomechanical abnormality, where certain tendons, ligaments, and supportive structures of the first metatarsal are no longer functioning correctly. This biomechanical abnormality may be caused by a variety of conditions intrinsic to the structure of the foot–such as flat feet, excessive ligamentous flexibility, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although no experts are convinced that poor fitting footwear is the main cause of bunion formation , other sources concede only that footwear exacerbates the problem caused by the original genetic deformity.

Tight fitting shoes are thought to be the cause of bunions in about 90% of patients. Shoes such as high heels are particularly damaging to the toes. These shoes have a sloping foot piece and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box. The narrow toe box causes the toes to become squeezed together. Depending on factors such as duration of wearing constraining footwear, skeletal maturity, and individual factors, the toes can become permanently adapted to the new position and lead to the formation of a bunion.

Bunions can occur for a number of reasons, but a common cause is wearing shoes that fit too tightly. They can also develop as a result of inherited structural defect, injury, stress on your foot or another medical condition. A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. Your big toe joint becomes enlarged, forcing the toe to crowd against your other toes. This puts pressure on your big toe joint, pushing it outward beyond the normal profile of your foot, and resulting in pain. Bunions can also occur on the joint of your little toe (bunionette).

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This is not a substitute for professional medical advice. Seek the guidance of a licensed physician if you need medical advice.

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