There is no genetic component to bunions.  Like spurs, they are formed when enough stress or compression is applied to the first metatarsal joint.  Many people who come to us for help may have heard that their bunions are hereditary, through their parents or grandparents.  We can see the apparent thread of logic but contrary to public opinion, bunions are created by compression, by ill-fitting footwear.

A bunion is a bone's response to stress. When enough pressure is applied to the hallux (big toe) or the first metatarsal head over a significant period of time, the bone produces calcium to protect itself.   The result is an enlargement of that joint and the accompanying deformation and deviation of the hallux itself.  A bunion can be formed in as little as 18 months.

Remember, the human foot must not be compressed except in its reaction with the ground.   But a bunion can be formed even by compression from below if conditions are right, that is, if the pressure is focused and constant enough.  Most Americans live at least 12 hours per day in a concave insole environment where the metatarsal heads #2, #3 and #4 sink down into the insole of the shoe and metatarsal heads #1 and #5 are pulled upwards.  This puts constant pressure on those outer metatarsal heads, the sites where most bunions are formed.

Orthotics are essential to the management of a foot with a bunion.  Orthotics redistribute the body’s weight on the first metatarsal head to the entire plantar surface of the foot. 

Socks alone can cause compression of the foot by simply pulling on the toes.  That seemingly small amount of compression can exacerbate and escalate an already existing bunion.  It has been years since Americans have had real socks at their disposal;  fitted socks that do not pull on toes.  At Goodhart Shoes we carry only MarcMarcs and Falke socks from Germany.  MarcMarcs and Falke socks come in sizes.  They stay in place on your heel and will not pull on your toes. 

Surgery is indicated only when the bunion is so large and advanced that the foot will no longer enter into the widest, most accommodative shoe or when pain is constant, in short, when the bunion cannot be managed.  We see those feet once every few years and refer those patients to an orthopedic surgeon.  But remember, a bunionectomy is a temporary procedure if proper footwear is not adopted postoperatively and if the shoe environments that produced the bunion in the first place are not rejected. 

Your bunion will not go away. But if you do the right thing and wear your Goodhart shoes and MarcMarcs and Falke socks your bunion won’t really bother you at all.  You can be pain free in regard to your bunion.