What Causes Bunions?

Bunions don’t just show up one day. They typically develop over years as your big toe gradually drifts toward your other toes. This pushes the joint at the base of the big toe (metatarsophalangeal joint) outward and creates that telltale bump on the side of your foot.

At Cascade Foot & Ankle Center in Provo and Nephi, Utah, board-certified podiatric surgeon and wound care specialist Jared Clegg, DPM, FACFAS, and our team help patients understand why bunions form and how to slow their progression or eliminate the pain they cause.

Why bunions develop in the first place

Bunions are bone deformities that form when your big toe joint becomes unstable and stops working the way it should. 

The metatarsophalangeal (MTP) joint sits at the base of your big toe, connecting the first metatarsal bone to the toe itself. Every time you take a step, this joint handles a large portion of your body weight.

When the joint can’t stay properly aligned under that pressure, your big toe starts drifting toward your second toe. The metatarsal bone pushes out in the opposite direction, which is what creates the bump you see on the inside of your foot.

Genetics determines who’s prone to bunions

If your parents had bunions, you may inherit the same foot structure that predisposes them to bunions. The specific shape of your metatarsal bones, how flexible your ligaments are, and the way you naturally walk all come from your genes.

Flat feet put extra pressure on the joint

People with flat arches tend to overpronate, which means their feet roll inward too much with each step. This motion puts constant stress on the big toe joint. After years of that repeated pressure, the joint can’t maintain its alignment, and a bunion starts to form.

Loose ligaments allow too much movement

Some people are born with ligaments that stretch more than they should. This hypermobility means the big toe joint shifts too easily when you walk or stand. Even without flat feet or other problems, loose ligaments can be enough to let a bunion develop.

Shoes can make a bunion worse

Footwear doesn’t usually cause bunions in feet with normal structure and mechanics. But if you already have the inherited foot shape that predisposes you to bunions, narrow toe boxes and high heels can accelerate their development. 

Tight, pointed shoes squeeze your toes together and shift your body weight forward onto the ball of your foot, placing extra pressure on the already vulnerable MTP joint.

Slowing down bunion progression

There are a few things you can do to slow progression and potentially delay when a bunion becomes painful enough to need treatment.

Dr. Clegg recommends:

• Wide toe boxes and good arch support in all footwear
• Custom orthotics to correct flat feet and overpronation
• Healthy weight maintenance to reduce the force on your feet
• Avoiding high heels and pointed shoes for extended periods

These steps won’t reverse a bunion, but they reduce unnecessary stress on your big toe joint.

Conservative care and surgical correction

Early-stage bunions often respond well to padding, taping, anti-inflammatory medications, and shoe modifications. These approaches manage pain and can stop progression for many people, but they won’t make the bunion disappear.

When conservative treatment no longer controls your symptoms — when the pain interferes with daily activities or finding shoes that fit becomes impossible — surgery realigns the bones, removes the bony prominence, and corrects the angle of your big toe. 

Dr. Clegg uses several surgical techniques depending on the severity of your bunion and your specific foot structure.

Bunion treatment in Provo or Nephi, Utah

Bunions won’t improve on their own, but with the right treatment approach, you can manage pain and maintain your mobility. Call Cascade Foot & Ankle Center or schedule an appointment online to have Dr. Clegg evaluate your bunion and develop a treatment plan.