The 5 Most Common Reasons for Bunions

Understanding Bunions: The Top 5 Causes of This Foot Deformity

By Duyen Nguyen of Rose Bay Podiatry

Bunions, otherwise medically known as a “Hallux Valgus” deformity or a HAV, are a common foot deformity with its prevalence increasing with age and more commonly affecting females.

Bunions are a result of the big toe travelling towards the lesser toes, and the top of the 1st metatarsal (the bone connecting the toe to the foot) moving in the opposite direction causing a lump on the side of the foot.

The changes at this joint can lead to arthritis or joint wear and tear, and result in anatomical changes to your feet, your gait pattern, difficulty in finding comfortable and appropriate fitting footwear and ultimately pain.

Bunions can be sometimes be asymptomatic (pain-free) and only present as a bony deformity, but in some people can lead to swelling, inflammation and pain due to increased pressures while in shoes and walking or the development of a bursitis or synovitis.

What causes a bunion to develop?

1) Hereditary, family history

Genetic factors play a contributing factor in your likelihood to develop bunions. If your mother, father or grandparents have had bunions, you are likely to have also inherited the mechanical structural weakness. Genetic factors that influence the development of bunions can include your natural gait pattern, the anatomical structure of your feet, your foot posture and inherited inflammatory joint conditions.

2) Ill-fitting footwear

Ill-fitting and inappropriate footwear is one of the leading causes for the development of bunions. Narrow, tight and heeled footwear increase the pressure at the forefoot resulting in crowding of the toes and altering the structural shape of the foot. Having correct fitting and supportive footwear is the first step in finding comfort for your feet, and also the best conservative treatment in managing and preventing the progression of bunions.

3)  Anatomical structures of your feet

The human body is designed to work in an ideal alignment, as to ultimately move and work in the most efficient manner. Unfortunately for most, we are not all created the same and in the ideal way. Abnormal anatomical structures such as a shorter 1st metatarsal bone and a longer second metatarsal bone can increase the risk and development of a bunion. The altered anatomical structure can lead to a muscle imbalance in the foot, thereby impacting the structures that help create a stable 1st metatarsophalangeal joint.

4) Foot posture and alignment

Those who excessively pronate, or have a “flat” foot posture are at risk of developing a bunion. Just as a car works, the foot works on different gears to move efficiently and effectively, that is, on a high and low gear. The body is designed to propel off of the 1st metatarsophalangeal joint, this allows the body to work and move in its most efficient state. For those who excessively pronate, they work on a lower gear axis which can result in the body overcompensating and working harder to propel their body forward. Over time this compensatory pattern of walking can lead to muscle imbalances in the foot and encourage the progression of a bunion. Through the use of orthotic devices to correct alignment and with the use of correct footwear, you will be able to move more efficiently and increase foot comfort. 

5) Inflammatory Joint conditions

Inflammatory joint conditions such as Osteoarthritis or Rheumatoid arthritis can lead to a bunion developing. The arthritic alterations to the joint space at the 1st metatarsophalangeal joint, cartilage erosion and exostosis formation, can alter the joint movement and a person’s gait pattern. Therefore lead to misalignment of the joint.

If you are concerned with the position of your toes, have pain in the ball of your foot or think you may be developing a bunion a podiatrist should be your first point of call