A bunion is a deformity of the big toe. People with a bunion have a toe that points outward, as well as a bump on the inner side of the foot. As the bunion becomes more prominent, pain can develop.
Bunions are a common problem that can cause foot pain and difficulty wearing shoes. Bunions occur in about 30% of the population of most Western countries. They are seen most commonly in women and become more common as people get older.
Tight-fitting shoes are thought to be the cause of bunions in most patients. Shoes such as high heels or cowboy boots are particularly damaging to the toes. These shoes have a sloping foot bed and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box, causing 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 adapted to the new position and lead to the deformity we know as a bunion.
Footwear is not the only cause of a bunion. Genetics do play a significant role, and people who have bunions in the family are also much more likely to have bunion than people who do not. Injuries to the foot can also be a factor in developing a bunion. Many people who have a bunion have a combination of factors that makes them susceptible to having this condition. For example, women over the age of forty who have a family history of bunions, and often wear high-heeled shoes, would be considered likely to develop a bunion.
The best approach in deciding what to do about a developing bunion is to get an X-ray early in the progression of the deformity to gain an understanding of what is the best intervention to either prevent the deformity from increasing in severity or correcting the deformity before permanent arthritic changes occur to the joint that cannot be reversed with corrective surgery.