What are the two causes of bunions?
Posted: Mar 24, 2022
Bunions are an enlargement of the big toe joint that may become painful and is associated with a deviation of the big toe over towards the lessor toes. There are only two things that can cause bunions: a genetic predisposition and poor fitting footwear.
There is not much you can do about the genetic or hereditary predisposition as you get that from your parents. If you want to blame someone, then blame your parents. The research has shown that it is possibly an autosomal dominant trait. This does not mean that you will get a bunion, it just means that you are at a greater risk of getting a bunion. This manifests in the biomechanics of your foot and how your foot functions. Biomechanics plays an important role in the development of bunions and is a significant factor in how fast a bunion progresses. There are some things that podiatrists can do to try and improve the biomechanics of the foot that might make a difference to the long-term outcome.
The other big factor in the cause of bunions is the choice of footwear and that is something that you can change and make choices that can affect the outcome of bunions. Footwear that is too narrow across the forefoot that pushes over the big toe and pushes on the joint is clearly the main risk factor for bunions. Combine these tighter fitting shoes with the hereditary risk factors and bunions are highly likely to happen eventually. The issue will be how much and how often you use the poor fitting footwear. Even if you do not have the genetic predisposition from your parents, the wearing of poor fitting shoes is still a risk, but probably not as much as if you are genetically predisposed. Footwear is also responsible for causing the pressure over the enlarged bunion that makes them painful. This is assumed to be the reason why bunions are more common in females as they tend to wear higher heel tighter fitting dress shoes more often. However, the increased incidence in females could also be due to hormone difference between males and females and how those hormones affect the ligaments around the joints.
Interestingly, bunion still do occur in those who do not wear shoes, so shoes are not the entire issue. However, in these populations the bunions are never that bad and never get painful. Wearing footwear makes them worse, makes them progress more and makes them painful. There is also evidence from archaeological digs that there was a big increase in bunions in skeletons from medieval times when they started wearing tighter fitting shoes.
Bunions can be prevented if you deal with the risk factors early enough. The wearing of shoes that are wide enough to not cause the pressure on the big toe is one of the more important preventative measures. If you have a genetic predisposition, then it is even more important you do this as you can not change your genetic parents. Understanding the cause of bunions is the first step to preventing them.
Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.