Why Do I Have Bunions?
By Dr Rion Berg
March 28, 2018
Category: Bunions
Tags: bunions  

Like most people, you probably know what a bunion looks like. Maybe you have a bunion and you've been dealing with it for a long time. Perhaps as you've gotten older your bunion has progressed and it's become painful to wear closed-toed shoes.

You may have wondered, why you have bunions. Is it just bad luck or is something else going on.

Are Bunions Genetic?

Bunions are not genetic but the underlying foot mechanics that cause bunions are inherited. Each of us is born with a particular foot type. Although babies are all born with flat feet most will outgrow this flat foot pattern at around age four. Those who do not outgrow them will have flat feet for the rest of their lives.

People with flat feet are at much greater risk for developing bunions.


Men and women with flat feet you are much more likely to pronate or roll their feet inward when they walk. This walking pattern is what causes bunions to form over time.

What Is Going On With My Bones?

The first thing you notice if you have a bunion is the characteristic bump at the base of your big toe. You might wonder if you're growing extra bone, but you are not. In a foot without a bunion, the toe is relatively straight ahead. 

With a bunion you can see on X-ray that the big toe is moving towards the second toe. In addition, you'll notice the first metatarsal separates from the second metatarsal. Without any bone formation, a bump begins to form on the side of the joint.

In addition, the first segment of the great toe and the metatarsal behind it often become hypermobile. As this happens greater and greater separation occurs between the first and second metatarsal causing the toe to drift over.

Let's compare this to your hand. Unlike the great toe, mobility is necessary or you wouldn't be able to touch your thumb to your little finger. If you make a fist with your right hand you'll notice a bump where your thumb knuckle protrudes out. Unless you plan to write with your feet, you don't need that hypermobility.

The hypermobility comes from the tendency of the foot to pronate as mentioned earlier. It's this hypermobility that causes the great toe to drift over toward the smaller toes.

What Causes the Pain?

The pain is not a result having a hypermobile big toe with a bump. It results from your bunion rubbing against your shoes every time you walk. If you lived in a place where the weather is always warm bunions would not be much of an issue since you could accommodate them with a pair of sandals. In a place like Seattle this is a much bigger problem as we need shoes almost all year long. Most shoes are not designed to accommodate bunions.

How Is It Treated?

The earlier you get the underlying cause of the bunion treated, the better chance you have of preventing bunions from forming. For example, children who have not outgrown their flat feet from babyhood can receive treatment to prevent bunions. At the Foot and Ankle Center of Lake City we treat young children with pediatric flatfoot with a special pre-fabricated orthotic designed just for kids called Little Steps. To learn how to identify children foot problems early review Kid's Feet First.

For adolescents whose feet are still growing I'll recommend a splint for nighttime wear to keep the toes aligned properly. For adults as well as adolescents custom orthotics are recommended. Orthotics keep the foot properly aligned when walking to prevent pronation and the first toe from becoming more hypermobile.

Wearing shoes that can properly accommodate your bunion can help prevent bunion pain. A local shoe store I recommend is Sole Perfection. In addition, Kirsten Borrink's website, www.barkingdogshoes.com is a great resource. She is always finding new shoes that work for a variety of foot problems including bunions.

What About Surgery?

After all conservative treatment approaches are tried; surgery may be the most reasonable option. Most people who have surgery have had bunions for many years, but young people can also have an advanced case and prefer a surgical solution. Either way it's important to ask yourself the following questions before talking to a Seattle podiatrist like me about surgery.

Are my bunions more painful?
As bunions progress they often become more painful. If this is a problem for you and you've tried other solutions.

Has it become extremely difficult to wear shoes?
At some point the difficulty of finding any shoes to wear (even bunion-friendly shoes) may have become problematic.

Has my bunion discomfort forced me to limit the activities I wish to pursue?
For many people, giving up athletics or fitness activities is not acceptable. If this is true for you then surgery may be the best option

If you or a loved one are suffering from bunions, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+