Bunions are one of the most common foot deformities in the United States, particularly among older women. By some accounts, up to 50% of women may develop one at some point in her life, but even younger people get them too. Men appear to be lucky and not have as high of occurrence.
Bunions form when the largest toe becomes misaligned at the base of the joint—known as the metatarsophalangeal joint or MTPJ. Two things will occur. First, the big toe begins to drift inward, smashing into (or even crossing overtop) the second toe. Second, an obvious enlargement of bone forms on the inside of the foot at the MTPJ. (When the little toe does something similar on the opposite side, it’s called a tailor’s bunion or
Where Bunions Come From—Nature vs. Nurture
Bunions have been associated with certain lifestyle choices—for example, regularly wearing high heeled shoes or footwear with tight, constricting toe boxes. These choices do not create the deformity but will accelerate the progression of an existing bunion and often aggravate a painful response. It’s perhaps not surprising, then, that about 90% of bunion patients are women.
That said, the fundamental cause of most bunions are related to heredity. Most people don’t have perfect feet—in fact, up to 60% of the population inherited some kind of mechanical flaw in their foot structure, and certain flaws predispose a person to
Opportunities for Conservative Care
It’s important to realize that
If the bunion remains relatively small and mild, and your pain is still minimal, taking immediate conservative measures may help you slow the rate of progression, preventing or at least delaying the need for surgery for some period of time. On the other side of the coin, the longer the bunion is present, the more additional procedures may be required to fix other problems such as hammertoes and transferred pressure on the adjacent bones.
It may take 3-4 decades for a bunion to reveal itself. There is a juvenile version that presents very early in life (during the pre-teen years). There is typically no distress since this age group uses athletic shoes. Bone growth plates are still active and it is recommended that surgery
The most convenient measure may simply be to find a comfortable pair of shoes that provide adequate room for your deformity. We can also help you with padding or taping (if the joint remains sufficiently flexible) or provide custom orthotics to accommodate an underlying structural issue.
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