What Causes Bunions?

Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics. The foot may be flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arthritis or an injury produces a bunion. And some people are born with the tendency to develop bunions. If you're at risk for developing a bunion, wearing high-heeled or poorly fitting shoes makes the problem worse.


bunion bony bump

A bunion is a bony bump, usually near the joint at the base of the big toe

Your big toe is the hardest-working toe. Every time your foot pushes off the ground, this toe supports most of your body's weight. Because the big toe is so critical to movement, any problem with it can make walking or even standing painful.

A bunion (excess or misalligned bone in the joint) is one of the most common big toe problems. In addition to causing pain,   a bunion changes the shape of your foot, making it harder to find shoes that fit. But you don't have to hobble for the rest of your life. Bunions can be treated. With       your doctor's help, your feet can feel and look better.




F o o t n o t e  

Squeezing a square-shaped foot into a shoe with a pointed toe increases the risk of a painful bunion.

  Types of Bunions   

Positional (mild) bunions arise from the growth of new bone. Structural (severe) bunions result when the joint at the base of the toe shifts position. Many bunions are a combination of both types.


Positional Bunions

Structural Bunions    

A new bone grows, the joint enlarges. This stretches the joint's outer covering. Force created by the stretching pushes the big toe toward the smaller ones. Eventually, the inside tendons tighten, pulling the big toe farther out of       alignment.


When the angle between the bones of the first and second toes is greater than normal, the big toe slants toward the smaller ones. In severe cases, this may also cause the second and third toes to buckle.

positional bunion

structural bunions




Physical Exam 
To determine the best treatment for your problem, your doctor may ask if and when your bunion causes pain. Your doctor may also test how far and how smoothly the affected joint moves. To see if incorrect foot mechanics is causing your problem, your doctor may watch how your feet rotate and flatten as you walk.   


X-rays may be taken of your foot to show the position of the big toe joint. Your doctor may also want to see whether the bunion is affecting other bones in your foot. 

bunion x-ray



bunions testing joints 








To see how well a joint works and to learn if movement causes pain, your doctor may move the joint back and forth.


How Are Bunions Treated?

If a bunion is not painful or severe, your doctor may recommend that you wear a different style of shoes. Or you may be prescribed custom-made shoe inserts (orthoses) to control incorrect foot mechanics. For painful or severe bunions, outpatient surgery may be recommended. After surgery, you'll be on your way home and ready for recovery.


Shifting Soft Tissue


 Shifting Bone


Removing Bone  

To realign the affected joint, any tight tendons on the inside of the toe are realeased (cut.) New bone that makes up the bunion is shaved away.    The most common bunion surgery reduces the angle between the first and second toes. Bones in the big toe joint are realigned and the bunion is shaved away. Ligaments and tendons around the joint may be tightened to hold it properly in place.    If a structured bunion is severe, a piece of bone is removed from the first metatarsal (the long bone behind the big toe joint.) Once repositioned, this bone may be held in place with a pin or a screw. Any new bone that makes up a bunion is shaved away.



tendon released

Tendon Released


repositioned bone

Bone Repositioned 


bone removal

Bone Removed