A bunion is a painful bump that occurs along the side of the big toe joint, at the ball of the foot. There is bursitis or swelling at the side of the big toe joint and very often there is a build-up or thickening of the bone as well. Often the big toe is deviated laterally or towards the lesser toes and the 1st metatarsal bone at the side of the foot is angulated as well.

Early Signs
Bunions can appear as early as teenage years, but more commonly they tend to slowly progress and show up in the 20 to 30 age group as an early bunion development. If left untreated over the years, the big toe tends to drift further towards the lesser toes and the build-up at the side of the big toe joint tends to worsen.

Shoes and Bunions
Many people are surprised to discover that they have bunions even though they have worn comfortable shoes all their lives. Obviously a woman’s dress shoe will aggravate a bunion problem if it is narrow or pointed and squeezes the toes. Bunions can and do occur in men as well. In fact, bunions occur in non-shoe wearing populations in Africa.

Cause of Bunions
Shoes tend to aggravate a pre-existing problem, but it is the foot mechanics that usually causes the bunion problem. The foot structure that one is born with can create bunions in later life. We find that teenagers and children who have flat feet, and whose parents or grandparents have bunions, may very well go on to develop a bunion problem unless treated preventively. Flat feet (pronation) causes bunions. The reason for this is that when someone with a flattened foot walks, instead of pushing off the bottom of the big toe, the foot rolls in towards the other foot and the pressure during the push-off phase of the gait cycle is at the side of the big toe rather than the bottom of the big toe. This pushes the big toe towards the lesser toes. At the big toe joint, continual pressure builds up more bone over the years, and this bone is actually the bunion problem. The overlying bursa, or protective fluid filled sac at the side of the big toe joint, becomes inflamed and this is the bursitis (swelling), redness and pain that goes along with the bunion problem.

Obviously, avoiding shoes that press on the bunion is helpful, however if the bunion is in its fairly early stages, surgery can often be avoided and symptoms relieved. Correcting the foot mechanics if someone has a flat foot is the key in preventing the progression of the bunion problem. Note also that someone with a very high arch foot type can develop bunions because of the constant jarring on the big toe joint as well.

In order to relieve the symptoms of a bunion, besides comfortable footwear and the correction of one’s foot mechanics with orthotics, we often use accommodative padding or small 1/8th inch adhesive felt pads that can be placed behind the big toe joint or bump of the bunion in order to reduce shoe pressure.

Most of the time bunions can be prevented from progressing so that surgery can be avoided.

Recommended Approach

Try to avoid surgery, wear proper orthotics (that are prescribed for you), apply those 1/8" adhesive pads to avoid shoe pressure, and be careful about the shoes you wear.

If you are having mild discomfort from a bunion, the chances are you don’t need surgery. Your foot mechanics should be assessed to determine why you are developing the problem and whether or not changing the way you are walking with an orthotic device would alleviate the pressure on the bunion. This along with some padding and ice may circumvent surgery.
At Academy Foot and Orthotic Clinics, we never, ever recommend surgery as we practice conservative care where we avoid surgery and harmful medications at all cost.  There is no surgery or medication that does not have side-effects, sometimes life threatening. 
If you or a loved one would like to be treated with the highest regard, please do not hesitate to contact Doctor John A. Hardy's Toronto Foot Clinic, Academy Foot and Orthotic Clinics.
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.



Academy Clinics has a special interest in high quality custom orthotics.



Toronto, ON Chiropodist
Academy Foot and Orthotic

Toronto, ON M4K 2P1 

Across from the Broadview Subway
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