Bunions are a common foot deformity that can cause significant discomfort and impact daily mobility. Characterised by a bony bump at the base of the big toe, bunions develop gradually and are often linked to structural issues within the foot. While anyone can develop them, research shows they are far more prevalent among women. In fact, up to 23% of adults are affected by bunions, with some studies indicating that as many as one in three people may experience them. Women are two to ten times more likely than men to develop bunions and account for approximately 85% of bunion-related surgeries.
Understanding what bunions are and their causes
A bunion, medically known as hallux valgus, is a bony deformity at the base of the big toe where the first metatarsal shifts outward and the big toe leans inwards toward the second toe, widening the forefoot. It’s often visible as a red, painful bump on the side of the joint. Over time, complications like bursitis or arthritis can develop
Causes
The exact cause of bunions remains uncertain, though several contributing factors are believed to play a role: Inherited foot structure or shape Foot injuries or long-term stress on the feet Congenital foot deformities (present from birth) Experts are divided on how much shoes contribute. Some believe that wearing tight, narrow, or high-heeled footwear can lead to bunions, while others argue that poor footwear mainly worsens an existing tendency. Bunions are also associated with certain types of arthritis, particularly inflammatory forms like rheumatoid arthritis, where joint swelling is caused by immune system dysfunction.
Common symptoms of a bunion include
A noticeable bump on the outer edge at the base of the big toe Swelling, discolouration, or tenderness around the big toe joint Corns or calluses often develop where the big toe overlaps or presses against the second toe Persistent or intermittent foot pain Stiffness or reduced mobility in the big toe, which may cause difficulty walking Thickened or hardened skin on the sole
Key reasons why women are more prone to bunions
1. Footwear choices High heels and pointy shoes: These concentrate pressure on the big toe joint, forcing it out of alignment Narrow toe boxes: These compress the toes sideways. Even a half‑centimetre difference between foot and shoe width impacts foot health significantly 2. Foot anatomy and hormones Anatomical differences: Women generally have softer connective tissues, more flexible joints, narrower feet, and different bone structure (e.g., shorter first metatarsal), making them more susceptible to misalignment Hormonal influences: Pregnancy and menopause can loosen ligaments and change weight distribution, increasing joint instability and bunion risk 3. Genetic and biomechanical factors Family history: A large proportion of bunion sufferers have relatives with a similar foot structure or gait Foot mechanics: Conditions like flat feet (over‑pronation) add stress to the MTP joint, accelerating bunion development 4. Lifestyle and occupational stress Women often spend more time on their feet, working, caring, walking, adding prolonged pressure on the forefoot joints
Consequences of untreated bunions
Left unaddressed, bunions can lead to: Chronic pain and difficulty walking Arthritis or other secondary deformities like hammertoe Trouble finding comfortable footwear Also read | What is botulism? Understanding causes, symptoms, and why early detection is crucial