Foot Pain Treatment: Podiatrist Talks Bunion Causes, Pain & Treatment


Bunions are such an eye-sore! They can turn back the dial on even the hottest heels. But just what the heck are these thngs anyway?

We tapped Dr. Lowell Weil Jr., President of Weil Foot & Ankle Institute to get the 411 on what these pesky foot problems are really all about.

So Dr. Weil, can you offer us some professional info on what bunions are?

Contrary to common belief, bunions are not a bone growth. Instead, a bunion is a progressive change of position of bones in the foot.  Specifically, the bone commonly known as the bunion, is the 1st metatarsal. The first metatarsal moves away from the foot and is it changes, it pushes out the side of the foot where it appears as the "bunion bump."  

As the 1st metatarsal moves one direction, the big toe moves in the other direction and leans towards the 2nd toe.  These two bone changing position causes the 1st toe joint to be out of alignment and destabilizes the area leading to more progressive change and pain the joint.

Just how do bunions form?

The great majority of bunions are 90% genetic. The remaining 10% are caused by conditions such as rheumatoid arthritis and similar disorders.  The mechanics that are genetically inherited allow the bones to change position over time as described above.  

Women are more genetically prone than men to get bunions 10:1. If one has genetic predisposition to get bunions, outside influences such as tight shoes and high heels may speed the progression.  However, if one does not have genetic predisposition, tight and high heeled shoes will not cause a bunion.

Are there any potential treatments?

There are no effective preventive treatment for bunions.  Bracing or splinting the toe, different shoe gear or arch supports/custom orthotics have not shown any long term benefits in preventing the formation or progression of bunion deformity.  

When bunions become painful, getting into wider and/or deeper shoes may provide symptomatic relief. Devices to protect the area may also provide relief but often make the shoe fit tighter, leading to more discomfort.  When those alternatives are not effective, surgery is a consideration.  

Check out Part 2 of our discussion with Dr. Weil Monday for more information on treatments and just how prevalent bunions are. 

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