Bruce D. Gorlick, D.P.M., FACFAS    

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What is a bunion?
Bunions are a common problem that most people experience as a bony protuberance at the base of the big toe.  The word 'bunion' is derived from the Latin word bunio, which means turnip. The joint at the base of the great toe is complex.   The first toe joint has multiple sites of contact of bones, tendons and ligaments which work together to transmit and distribute the body's weight during standing and movement. Should this joint become abnormally stressed over an extended period of time, a bunion deformity may result. A bunion, however, is more complicated than simply a bump on the foot.  

When a patient has a bunion, the big toe creates an acute angle towards the lesser toes, a condition called hallux valgus. The angular deformity is a progressive disorder, usually worsening over time.  Bunions are more common in women, and the cause is usually due to improper footwear.

What causes a bunion?
Tight fitting shoes are thought to be the cause of bunions in about 90% of patients. Shoes such as high heels are particularly damaging to the toes. These shoes have a sloping foot piece and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box  The narrow toe box causes 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 permanently adapted to the new position and lead to the formation of a bunion.. 

A bunion is most often a symptom of faulty mechanics of the foot. The deformity runs in families, but it is the foot type or tendancy that is inherited, not the bunion. People with flat feet or low arches are more prone to develop the problem than those with higher arches. Bunions also may be associated with various forms of arthritis. Arthritis can cause the joint's protective covering of cartilage to deteriorate, leaving the joint damaged and with a decreased range of motion.

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Last modified: 12/19/06