You have pain in your big toe, the joint below your big toe is sore and stiff and a bump protrudes from the side of your foot, frequently ruining your footwear. You may have just discovered a bunion.

[caption id="attachment_5040" align="alignleft" width="360"]The protrusion at the base of the big toe is a bunion.[/caption]

Do shoes cause bunions?

It's commonly thought that high heels and other non-flat footwear are the cause of bunions. While these shoes aren't the primary reason for developing a bunion, they definitely contribute to their severity.

The truth is, some women can wear high heels their entire lives and never develop a bunion. Others can make all the right choices in footwear and still develop them. That's because the foot structure which contributes to a bunion is an inherited trait, especially common in men and women of European descent (but especially women). Any podiatric surgeon will tell you that he/she has treated bunions in multiple generations of the same family - usually mothers and daughters.

Our feet are designed to carry our body weight evenly across all planes of the foot. When we inherit the faulty biomechanics which lead to a bunion, and then stuff our feet into high heels and other shoes which don't support our feet correctly, a bad situation gets even worse. Shoes with heels shift our body weight onto the front of the foot, placing stress on an already weakened joint. Other factors which may contribute to bunions are obesity, spending lots of time on hard surfaces (like factory floors), jobs that demand a lot of time on your feet, and hormonal changes.

Will a bunion get better on its own?

What you see protruding from the side of your foot is a deformity of the joint at the base of the toe. The first metatarsal bone (the longest bone in the foot) has turned outward and the big toe has been pulled toward the other toes, causing the head of the metatarsal to protrude. As footwear rubs against this area, or body weight is shifted onto this joint via shoes with heels, the bursa which cushions and protects the joint becomes inflamed and sore, and the joint becomes stiff. The misalignment and compromised foot structure also causes pain on the side of your foot or in your arch, and pain and discomfort in the adjacent toes.

Unfortunately, a bunion is a progressive condition, which means it won't get better on its own. The longer you wait to treat the bunion, the worse it will become. There are stretching exercises and other therapies you can use to reduce the pain and progression of the bunion, but the only way to restore your foot to its pre-bunion condition is with bunion surgery.

What to do when you discover a bunion

• Stop wearing high heels or any other kind of shoes which don't support your feet correctly. This also includes inexpensive dress shoes (don't cheap-out in this department, guys!)
• When at all possible, wear a high quality pair of athletic shoes which cushion your feet and provide proper arch support
• Don't wear shoes that are too tight or pointed at the toes - opt for a wide toe box and a wider shoe in general
• See a podiatrist right away to establish a baseline. A podiatrist can treat your bunion with non-surgical measures like stretching exercises to reduce bunion pain, bunion splints, toe spacers or custom orthotics.

The faulty biomechanics that cause a bunion also contribute to other foot conditions as well, such as hammer toes, overlapping toes, corns, and ingrown toenails.