What causes bunions

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Orthopedic Surgeon, talks about what causes bunions and how they can be managed.

Orthopedic Surgeon, talks about what causes bunions and how they can be managed.

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Video transcript

Dr. Ajay Manjoo, MD, FRCSC, BSc., Orthopedic Surgeon

Duration: 1:59

Bunion deformities are otherwise known as hallux valgus deformities. Bunions can be painful for a number of reasons, primarily because the forefoot is wider and as such makes wearing shoes uncomfortable. With advanced bunions there could also be osteoarthritic changes in the joint of the big toe which can also contribute to pain. The cause of bunions is multifactorial. They are often times hereditary and may also be caused, or worsened, by wearing poorly fitting shoes; in particular shoes with a narrow-pointed toe box that forces the toe inwards. Bunions can also be seen in patients with certain medical conditions such as rheumatoid arthritis and some neuromuscular conditions that alter the balance of the tendons in the foot resulting in an abnormal position of the foot. Bunions can cause pain especially in tighter shoes. They can affect your ability to walk and to exercise. Bunions generally progress over time however it is difficult to predict how rapidly and how severely they will progress. We do know that with certain medical conditions, such as rheumatoid arthritis, they generally tend to progress faster and result in more severe deformities. However, with newer treatments for rheumatoid arthritis we do not see this as often.

Management of bunions can start off with shoe wear alteration – wearing a shoe with a wider toe box to relieve the pressure on the bunion and also to prevent progression. However, patients who do not respond to this surgical intervention may be candidates for surgical correction. Surgical correction depends on the severity of the condition. Your surgeon will examine x-rays of your foot taken with you standing as this gives a better idea of the severity of the deformity. Based on the angles of the bones in the foot, primarily the angle of the 1st and 2nd metatarsal, as well as the angle between the big toe and the metatarsal, the bunion is classified into mild, moderate or severe.

Presenter: Dr. Ajay Manjoo, Orthopaedic Surgeon, Toronto, ON

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This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.