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How Do Bunions Develop?

If you have a bunion that makes it hard to choose shoes and a little embarrassing to go barefoot, studies show you can probably blame your family. Technically called hallux valgus, bunions plague about 60% of the adult population, and of those, 63-90% can tag the condition to inherited family traits. 

While other factors play a role in speeding up the onset or worsening the development of bunions, such as age, improper footwear, gender, and excess weight, they are not considered the primary causes.  

Many patients who come to see us here at Frazier Foot and Ankle Center are surprised to learn that having a close family relative who has bunions increases their own risk. But knowing that gives you a leg up on preventing a bunion from appearing in the first place. If you’re genetically likely to get a bunion, Dr. Michael Frazier can help you take steps to avoid the painful foot deformity. 

If you already have a bunion or two, he guides you through the lifestyle changes that help you manage your discomfort and offers the most advanced treatments when you need a more assertive approach.  

The lowdown on bunions

When a bunion first begins to develop, it usually looks like some type of strange growth on the side of your foot. Then, as the bump gets bigger over time, it may begin to rub against the inside of your shoe, causing a painful sore to form over the bump.

But what appears as a bump, growth, or even as a big sore on the outside is actually the result of a bone deformity on the inside.

Bunions occur when the metatarsophalangeal (MTP) joint — the joint that attaches the base of your big toe to your foot — shifts out of place. This movement causes your big toe to bend inward toward the others and your joint to angle outward, which is what eventually leads to the formation of a bunion. The bump itself is actually a protrusion of bone.

Because the MTP joint bears a substantial amount of your body weight, a bunion can be especially painful when you’re standing, walking, or running. The joint itself may also become chronically stiff and sore, making it virtually impossible to wear shoes.

Bunions can also develop on the outside of your foot near your little toe. These smaller, so-called “tailor’s bunions” can be just as painful.

So what exactly causes bunions?

Bunions tend to run in families. If your great-grandmother, grandmother, and mother all developed bunions, there’s a pretty good chance that you’ll get one at some point, too. But why is this the case?

Medical researchers believe that, in many cases, a certain inherited foot type is what makes a person prone to developing bunions. Having an inherited, faulty foot structure leads to poor foot mechanics, which in turn causes increased pressure both on and within the foot.  

Still, there are people with bunions who don’t have a family history of the disorder. What causes them to develop bunions? Some people are born with congenital foot deformities that make bunions more likely, while others develop bunions after suffering some kind of injury or trauma to the MTP joint. People who have rheumatoid arthritis are also more likely to develop bunions.  

People with certain neuromuscular disorders have a greater chance of having bunions, too, as do people who are flat-footed or have low arches. Some women find this out during pregnancy, when their shifting hormones loosen their ligaments, flatten their feet, and cause them to develop bunions.

Can wearing the wrong shoes cause bunions?

Bunions are the direct result of years of abnormal pressure over the MTP joint. Put another way, improper foot mechanics lead to MTP joint instability, and this instability often leads to bunions.

So how do tight, narrow, or high-heeled shoes play a role in bunion development?

Shoes that don’t fit properly can exacerbate any underlying structural or stability issue, triggering the formation of a bunion much sooner than one would otherwise have appeared. Narrow shoes cause both your big toe and your pinkie toe to squeeze inward, while high heels force your toes forward and substantially increase the amount of pressure they’re under.

While some foot specialists believe bunions can be the direct result of improper footwear, most experts agree that wearing the wrong shoes simply exacerbates the underlying structural problem and makes bunions develop more quickly. After all, not all women who develop bunions wear tight, narrow shoes or high heels.

People who have jobs that require them to stand, walk, or put undue stress on their feet are also more prone to bunions. Ballet teachers, mail carriers, and teachers are just a few of the people who are more likely to develop bunions.

Preventing bunions

If bunions run in your family, take preventive steps to avoid developing one yourself. One of the easiest things you can do to support your MTP joint and prevent bunions is to wear proper shoes. First and foremost, all of your footwear should conform to the shape of your foot without squeezing or constricting your toes or any other part of your foot.

Your shoes should also have a wide toe box (avoid pointy-toed footwear, even when it’s trending), and make sure there’s some space between the tip of your longest toe and the end of the shoe.    

If you suspect a bunion is already on its way, come in and see us at Frazier Foot and Ankle Clinic. Dr. Frazier can help you improve your foot mechanics and give you other useful tips to slow its progression. Call our Cypress, Texas, office today, or make an appointment with our convenient online booking tool.

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