The medical term for ‘bunions’ is hallux abducto valgus (HAV), and what this terminology refers to is the bony lump that you often see at the base of the big toe, although it is occasionally seen on the little toe as well.
Bunions do not always cause symptoms immediately upon development but in most cases they eventually begin to cause pain. The level of discomfort depends on the severity of the growth and the activity level of the individual.
What Causes Bunions to Develop?
Bunions have been linked to the wearing of high heels and constrictive footwear, which squeezes the toes together and pulls the bones of the feet out of alignment. This helps to explain why women are affected at a much higher rate than men are.
Also, studies have shown that bunions are very rare in indigenous populations that do not wear shoes. The fact that bunions do occur in these cultures, however, means that footwear is not the sole factor in the development of this condition, although it does appear to be a primary contributor.
Though there are many possible causes in the development of bunions it is generally thought that an imbalance of pressures acting on the joints during weight bearing activities triggers this condition. This imbalance results in an unorthodox motion and unusual pressure points developing in the joints, and when this situation occurs over the term it leads to the development joint instability and bunions.
Bunions are essentially a symptom of sub-par foot mechanics that usually result from a combination of our walking patterns, the type of feet we are born with, and a poor choice in footwear.
Here is a summary of most common causes of bunion development:
- Biomechanical functions of the foot: An orthodox foot position during weight-bearing activities often causes problems.
- Genetics: There may be a predisposition to bunions found with particular typed of feet.
- Footwear: Constrictive shoes. Adequate space and support are necessary or else footwear can contribute to the development of a bunion.
- Activity Level: Activity levels may place too much stress on the foot. Activities may need to be altered or modified.
Bunions are usually the result of a combination of the factors listed above, although biomechanical abnormalities causing foot pronation are almost always present to some degree.
Pronation of the foot often leads to the development of bunions. When the feet tilt toward each other it displaces the first metatarsal as the big toe is simultaneously stretched and twisted as an overabundance of weight is shifted onto the inner portion of the foot. It is this cross-purposing that causes irritation and inflammation to develop in the bone and surrounding joint and tissues.
Interestingly, a bone will grow in such a way as to protect itself from further harm or injury and this can further inflame the joint tissue, which would then come into disproportionate contact with the bony enlargement. If care isn’t taken this cycle will exist in perpetuity or until the pain or debilitation becomes too great to ignore.
If this misalignment of bone is combined with ligamentous laxity, a high level of physical activity, inappropriate footwear, and/or a genetic predisposition to bunions chances are very high that this condition will occur and it will be both painful and debilitating.
Conservative treatments for bunions are usually the first resort and this often entails an attempt to correct the underlying problems such as biomechanical abnormalities, excessive pronation of the foot, and modification of foot wear. Foot orthoses are often used to correct unorthodox foot shape or function by aligning aspects of the feet differently.
If conservative treatments fail to remediate the problem or if the condition is severe then surgery will likely be considered as an option.