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Bunions: Causes, Prevention and Treatment

A bunion is an enlarged area of the inner portion of the joint located at the base of the big toe. The pronounced area is typically the result of a misalignment of the big toe joint, or in medical terminology – the metatarsal phalangeal joint (MTP Joint) The area can also, in some cases, contain additional bone.

The MTP joint can become red and inflamed and be very tender and quite painful. A small fluid-filled sac (bursa) adjacent to the joint can also become irritated leading to additional swelling, redness, and pain. This is referred to as bursitis. Untreated, the area may develop arthritis.

In addition, the misalignment causes the big toe to point outward and rotate toward the smaller toes. Untreated, this deformity will progress and increase with time although the painful symptoms may or may not. A less common bunion is called the bunionette. The bunionette is marked by its location – at the joint at the base of the smallest toe.

What Causes Bunions?

Bunions are thought to mainly come from over pronating. Pronation occurs as weight is transferred from the heel to the forefoot when walking or running and the foot naturally rolls inwards. A certain amount of this is natural but in many people the foot rolls in too much or over pronates.

Genetics seem to play a role. More specifically the genetic tendency towards over pronation can lead to development of bunions. Other causes which are less common include trauma, sprains, fractures, and nerve injuries. Also leg discrepancies (one leg being longer that the other) which results in over pronating can also be a determining factor.

Are Women or Men More Prone?

Women are the winners. Or should we say the losers. Bunions affect women nearly 10 times more frequently than men. Why is that? Look to women’s shoes for clues. Tight-fitting shoes, especially high-heel and narrow-toed shoes are the likely culprits putting women at higher risk for bunions.


Pain and discomfort can often be managed by getting rest and wearing looser, roomier shoes or sandals. However, make sure that whatever shoe you wear, it has a supportive sole. Stay away from high heels and try roomier, supportive sneakers. 

The next step to manage pain and discomfort are often anti-inflammatory medications along with ice packs applied to the area. Custom insole orthotics can also be used to slow the progression of the bunion and address underlying biomechanical causes such as over pronation.

Injection of cortisone is a step up in treatment and then finally a surgical procedure may be required. A bunionectomy can correct the deformity and relieve pain and radically improve the way the foot functions. These procedures typically involve removing bony growth of the bunion while realigning the big toe joint.

If you think your may have a Bunion or want to learn more about preventative care or treatments, please don’t hesitate to contact us for a diagnosis and the best in recommended care.

Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates  and schedule an appointment today.

To learn more about Bunions, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates


Francis J. Smith, D.P.M., A.B.F.A.S.
Board certified in Foot Surgery and Michael A. Klein, D.P.M. A.B.F.A.S.
Board certified in Foot Surgery​

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