Investigating Bunions: Are They Hereditary/Genetic?
Medical information provided by Steven Gershman DPM / Written by OrthoFeet Team on July 21, 2024 Blog HomeIntroduction to bunions
Bunions – those bony bumps that can form at the base of your big toe – are more common than you might think. Podiatrist Steven Gershman describes a bunion as a "bump on the inside (medial side) of the big toe joint". This occurs when the joint at the base of your big toe, where the first metatarsal bone meets the big toe, starts to misalign.
As Dr. Gershman explains, a bunion develops when this first metatarsal bone "slides out away from the second metatarsal" over time. This creates the protruding bump you see and feel. The big toe itself also gets pushed towards the second toe, causing the joint to twist. Bunion formation can lead to significant foot pain as the misalignment of the big toe often causes increased pressure on smaller toes, which may contribute to heel pain and overall discomfort. Sometimes, this area might also become inflamed and swollen, with a sac filled with fluid (bursa) forming around the bump.
Bunions can be a real nuisance. Finding comfortable shoes becomes a challenge as the bunion causes the foot to widen and the big toe gets pushed towards the second toe, potentially crowding and deforming it. On top of that, the displaced big toe can crowd and deform your second toe.
All that begs the question: what causes this condition? Are bunions hereditary or is there more to the story?
Genetic factors in bunion development
Bunions are quite common among adults, with women being more susceptible than men. Dr. Steven Gershman attributes this to women typically having "more flexible joints and ligaments". This flexibility can play a role, but genetics are a major contributing factor as well.
Inheriting specific foot shapes and structures can make you more prone to bunions [1]. These inherited traits can influence how your foot distributes weight and moves, potentially contributing to the misalignment that leads to bunions.
Are bunions genetic? Research is ongoing to fully understand the complex genetics of bunions. One study found a strong hereditary component, with bunion deformities present in at least two family members of 90% of the cases studied [2]. This suggests bunions may be passed down through generations.
Another study suggests multiple genes might be involved, interacting with sex hormones and influencing various biological pathways linked to osteoarthritis and skeletal development [1]. These pathways might explain why some people are more prone to bunion formation.
While many factors contribute to bunions, understanding your family history and genetic predisposition can be helpful. To further explore how different types of bunions may be influenced by genetics, read our detailed guide on Exploring the Different Types of Bunions.
Prevention and management strategies
For a new patient experiencing bunion pain, understanding the factors contributing to a developing bunion can be crucial for effective management.
Preventative footwear choices
Choosing the right orthopedic bunion shoes can play a significant role in preventing bunions, shrinking bunions, or keeping them from getting worse. Here's a guide to picking footwear that prioritizes your foot health.
Look for shoes with a wide, round toe box. This gives your toes ample wiggle room and prevents them from feeling squished together, which can irritate the bunion joint. For a range of footwear designed to accommodate bunions, check out our women’s shoes for bunions and men’s bunion shoes tailored for your comfort and health.
Extra depth in the toe box provides space to accommodate a bunion comfortably, allowing the big toe to sit naturally, even if it overlaps slightly with the second toe.
Standard width shoes just won't cut it. Opt for wide or extra wide options. Many specialty footwear brands offer a wider range of widths to ensure a proper fit that doesn't pinch your bunion.
Stiff, unforgiving materials are a big no-no. Opt for shoes with a more flexible construction, like those made from stretch knit uppers. These materials conform to the shape of your foot, including the bunion area, creating a pressure-free environment. Supple leathers can also be a good option.
Avoid shoes with bulky overlays or seams right over the bunion, as these can create irritation.
Choosing wide-fit shoes or stretching your own shoes for bunions can help alleviate discomfort and prevent further bunion deformity and bunion formation.
Wearing high heels can exacerbate foot pressure and contribute to developing a bunion. Choose shoes with a low heel or flats. Elevated heels force your foot forward, placing extra pressure on the forefoot and potentially worsening bunions.
Look for shoes with an ergonomic sole that promotes natural foot motion. A mild rocker bottom design can help distribute weight evenly across your foot, reducing stress on the forefoot.
It’s best to wear shoes with an orthotic insole that offers arch support, helping to control overpronation and realign the feet with the rest of the body to avoid putting excessive pressure on the bunion.
Exercises and foot care
While bunions can't be reversed with exercise alone, incorporating specific bunion exersices and foot care practices into your routine can strengthen your feet, improve flexibility, and potentially slow the progression of bunions. Here are some tips.
Exercises
Sit comfortably with your feet flat on the floor. Slowly point and curl your toes, working on flexing the muscles in your feet. Aim for 20 repetitions of pointing and curling, repeated in 2-3 sets for each foot.
While seated, place one foot flat on the floor. Keeping your heel grounded, lift and spread your toes as wide as possible. Hold for a few seconds, then relax. Repeat 10-20 times per foot.
Sitting in a chair, lean forward and gently grip your big toe. Make small circles with your toe, going clockwise 20 times, then reverse direction for another 20 circles. Repeat this 2-3 times for each toe [3].
Foot care
At the end of each day, especially if you typically spend long hours on your feet, treat yourself to a warm foot soak. Add a few tablespoons of Epsom salts to a warm basin of water and soak your feet for 20-30 minutes. This can help reduce inflammation and promote relaxation [3].
Treatment options for bunions
Non-surgical treatments
Surgery isn't always necessary. Here are various non-surgical treatment options you can explore to manage bunion pain and discomfort.
If your bunion is inflamed or irritated, applying cold therapy can help reduce pain and swelling. Wrap an ice pack in a thin towel and apply it to the bunion area for 15-20 minutes at a time. Repeat several times a day as needed.
Many people find relief with over-the-counter (OTC) pain relievers that can help manage pain and inflammation associated with bunions [3].
Over-the-counter gel pads can be placed directly on the bunion to protect it from rubbing and irritation caused by shoes [3].
Podiatrists might recommend padded shoe inserts to help distribute pressure more evenly as you walk. This can help prevent your bunion from worsening [3].
Maintaining a healthy weight reduces stress on your feet and big toe joints, potentially slowing bunion progression [4].
Opt for activities that are gentle on your feet, such as walking on soft surfaces or swimming [4].
When resting, elevate your feet to reduce swelling and pain [4].
Make sure to rest your feet regularly throughout the day, especially after you’ve been on your feet for some time [4].
Regularly massage your feet and gently move your big toe to maintain tissue flexibility and reduce stiffness [4].
When surgery is needed
If conservative treatments aren't effectively managing your bunion pain and impacting your daily activities, consulting a podiatrist is crucial. They can assess your situation and determine if surgery might be the best course of action.
The primary goal of bunion surgery is to alleviate pain and restore normal function to your toe.
Podiatrists have various surgical options available, and the choice often depends on the severity of your bunion. Here's a brief overview of some common procedures.
For less severe bunions, a bunionectomy is typically recommended by the American Podiatric Medical Association. This procedure involves removing the bony bump that characterizes a bunion.
An osteotomy surgery is recommended in more complex cases and involves cutting the bone in your big toe and realigning the joint to its proper position.
If you have severe arthritis alongside your bunion, a podiatrist might recommend an arthrodesis. In this procedure, the arthritic joint surfaces are removed and screws, wires, or plates are used to stabilize the bones while they heal in a corrected position [3].
Recovery time after bunion surgery varies depending on the specific procedure performed. Generally, you can expect some swelling, discomfort, and limitations on weight-bearing activities for several weeks. Your podiatrist will provide detailed recovery instructions, including physical therapy recommendations to regain strength and flexibility in your foot [3].
References
[1] Yi-Hsiang Hsu, Youfang Liu, Marian T Hannan, William Maixner, Shad B Smith, Luda Diatchenko, Yvonne M Golightly, Hylton B Menz, Virginia B Kraus, Michael Doherty, AG Wilson, Joanne M Jordan. Genome-wide association meta-analyses to identify common genetic variants associated with hallux valgus in Caucasian and African Americans. Journal of Medical Genetics. Accessed June 25, 2024. https://jmg.bmj.com/content/52/11/762.short
[2] Carlos Piqué-Vidal MD, María T. Solé MD , Jaume Antich MD. Hallux Valgus Inheritance: Pedigree Research in 350 Patients With Bunion Deformity. ScienceDirect. 25 April, 2007. Accessed June 25, 2024. https://www.sciencedirect.com/science/article/abs/pii/S1067251606005308
[3] Sara Lindberg. 10 Simple Exercises for Bunion Relief and Prevention. Healthline. July 9, 2019. Accessed June 25, 2024. https://www.healthline.com/health/bunion-exercises
[4] The Healthline Editorial Team. Minimize, Manage, and Prevent Bunions. Healthline. March 8, 2019. Accessed June 23, 2024. https://www.healthline.com/health/how-to-get-rid-of-bunions