Dear Alice,

What is the cause of bunions? A stubbed toe? Nutritional? Can the growth be stopped before a shoe doesn't fit? Why the occasional burning sensation when there is no pressure on the "bone?"

Dear Reader,

To understand the cause of bunions, it is helpful to know what a bunion is. "Bunion" is a specific term for a swollen, or inflamed, "bursa" located inside the joint at the base of the big toe. A "bursa" is a small, fluid-filled sac that provides cushioning and reduces friction, usually near joints where a tendon, or muscle, crosses over either bone or other muscles (see Bursitis under the Go Ask Alice! General Health archives).

The underlying cause of bunions is an abnormal outward projection of the joint at the base of the big toe (where the toe meets the rest of your foot), and an inward turning of the toe itself. This happens when the big toe is pushed over, or displaced, a little further than its normal range of motion would allow. Many people with bunions are genetically predisposed to the condition. It can be exacerbated and/or accelerated by wearing narrow, tight, and/or high-heeled shoes, although some people who develop bunions have worn wide, low-heeled, "sensible" shoes almost exclusively throughout their lives.

Once the joint has begun to protrude out beyond its normal alignment with the foot, it begins to rub against whatever shoe the foot happens to be in, causing the pain and inflammation characteristic of a bunion. Bunions start out small, but they usually become worse with time. When you first notice a bunion developing, you can do a few things to try to halt its growth:

  • If you wear high-heeled and/or narrow shoes, replace them with low- or no-heeled shoes that are wide through the toes.
  • Try wearing a toe pad (found at almost any store with a footcare section) to minimize the amount of friction your "baby" bunion experiences.

However, if the bunion has grown, you may need to have surgery to remove the swollen tissue. If you have a bunion that is already large and painful, your best bet is to have it looked at by a podiatrist. You may want to do so even if the bunion is still a new feature of your foot's landscape. A foot specialist may be able to recommend a few preventive measures to lower your chances of needing surgery in the future.

As for the burning sensation, this may simply be how you experience the uncomfortable, painful feeling in your foot created by the bunion. If the burning sensation becomes something you feel constantly, or if it affects the whole foot, or both feet, it may be an indication of another condition. If this is the case with you, this would be another good reason to consult with a podiatrist, or your primary health care provider.

Good luck!


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