The Different Causes of Bunions

A bunion is a deformity of the big toe. People with a bunion have a toe that points outward, as well as a bump on the inner side of the foot. As the bunion becomes more prominent, pain can develop. Learn what causes bunions and what can be done if you have a bunion.

An x-ray of feet with bunions
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Bunion Causes

Bunions are a common problem that can cause foot pain and difficulty wearing shoes. They are seen most commonly in women and become more common as people get older.


Genetics plays a significant role, and people who have bunions in the family are much more likely to have a bunion than people who do not. The shape and structure of your feet are probably the biggest culprits for an increased risk of developing a bunion. You have no control over that since it is inherited.

In one older study, 83 percent of people with bunions had a family history of bunions. A similar number had bunions on both feet, which the authors said was because the shape and function of a person's feet affect the risk of bunions.


It's difficult to know exactly how important footwear is in the development of bunions, but we know it is the only variable we can significantly control. Bunions are much less common in countries without Western footwear.

Tight-fitting shoes are a common cause of bunions. Shoes such as high heels or cowboy boots are particularly damaging to the toes. These shoes have a sloping footbed and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box, causing the toes to become squeezed together.

Depending on factors such as the duration of wearing constraining footwear, skeletal maturity, and individual factors, the toes can become adapted to the new position, which may lead to the deformity we know as a bunion.


During pregnancy, the hormone relaxin is released to allow ligaments to stretch to carry the baby and for childbirth. This hormone also stretches all ligaments in the body. which can flatten the feet and make bunions more prominent

Injuries and Inflammatory Conditions

Injuries to the foot can also be a factor in developing a bunion. A broken toe or any injured bone, muscle, or ligament in the foot can heal out of place or cause scar tissue to form, contributing to the development of a bunion.

People who have rheumatoid arthritis are more prone to bunions, as are people with neuromuscular conditions such as polio.

Contributing Factors

Many people who have a bunion have a combination of factors that make them susceptible to this condition. For example, women over the age of 40 who have a family history of bunions, and often wear high-heeled shoes would be considered likely to develop a bunion.

Footwear and Bunions

Regardless of whether shoes caused your bunion, you should stop wearing shoes that increase your pain.

If you've already developed a bunion, look for shoes with a wider toe box that is square rather than pointed to help reduce your pain. In addition, get sneakers with wider soft/ expansive athletic leisure material in the toe box of the sneaker. This will prevent it from irritating the bunion.


Orthotics and padded bunion shields can also help.

Orthotics will help with the biomechanics aspect of the bunion deformity, potentially realigning the bones and motion of the 1st metatarsal and big toe. This will help with small bunions.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Orthopaedic Surgeons. Bunions.

  2. U.S. National Library of Medicine Genetics Home Reference. Bunion.

  3. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007 Jul;28(7):759-77. doi:10.3113/FAI.2007.0759

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.