Podiatrist Questions Bunions

What can I do to prevent bunions?

I had a bunion removed recently because it was quite painful. What can I do to prevent developing any in the future?

15 Answers

Bunions are partly genetic. So check your parents and grandparent's feet. You'll get an idea of what to expect for yourself.
Prevention includes wearing shoes with proper arch supports. Avoid shoes that are flat on the inside. Avoiding tight shoes or shoes that narrow greatly at the toes (heels and men's fancy dress shoes ie Italian, Alligator, etc)
You want to avoid anything that will progress the big toe being pushed over away from the center of the body
Wearing appropriate shoes or custom-made orthotics is the best way to try to prevent a recurrence.

Jonathan M. Kletz, DPM
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To prevent bunion reoccurrence you have to balance your walking with supportive shoes and orthotics. A huge reason you developed a bunion is from inheritance from a family member, but they enlarge due to poor fitting shoes and your gait (walking) pattern. Orthotics hold your feet in a neutral position to decrease the chance of a returning bunion.
Although the cause of bunions can involve environmental, traumatic, and event systemic arthritic factors, the most common reason is familial or genetic. There is a notable genetic predisposition for women. What does this mean for prevention? It is quite challenging to impede progression. With that said, there are management measures that can be done to assist in the relief of localized pain and dysfunction without aggressive intervention such as surgery. Shoes with limited heel height not to exceed two inches with larger toe box to minimize compression is a great start. If there are identified overall biomechanical factors contributing to its presentation such as over pronation of the foot, orthotics controlling these factors may be of assistance. The marketed bunion splints have no evidence-based medicine or scientific support for the restoration of foot anatomy or retarding progression, but they may assist in local pain relief. Ultimately, if pain or dysfunction notably impacts the quality of life and failed these nonoperative measures, then surgery may be required.
Bunions are generally not preventable as the condition is largely genetic; however, its development and symptoms can be decreased with proper shoes and arch support to help control the abnormal biomechanics of the foot. I would generally recommend a custom-molded orthotic to fit in your shoe.

Ahmad Farah, DPM
Assuming the surgery worked well, there should be nothing to worry about. What you might consider as a fail safe is a properly fabricated orthotic.
If the correct procedure was performed your chances of a second bunion are minimal. If only a bump was removed then the chances of a secondary bunion increase. Aside from choosing better parents because this is a hereditary malady The only thing that might help prevent the second bunion would be very loose shoes.
If the procedure went well your bunion should not return. Orthotics are also helpful
Great question! First, there is a strong genetic component. Look at your family's feet; parents, grandparents, aunts, uncles, etc. Somebody gave you bunions. Now, look at your shoes, make sure they are supportive, and if they are too tight (pumps, etc.), they can rub and make the bump very sore. If that's the case, try getting them stretched out. Lastly, go to a podiatrist, talk to them, share your concerns, and get custom orthotics made for you...even if you have to pay a few hundred dollars out of pocket.

Good luck!

Dr. Siegel
The major cause of bunions is biomechanical. That being said avoiding tight or narrow shoes can certainly aggravate the condition.
Bunions are genetic, so your body will want to re-grow it in time. But, you can significantly slow down the process by wearing properly fitted shoes and custom orthotics.
If it was fixed correctly there is a small chance it returns. If it was not fixed with the right procedure there is a greater chance it returns. To prevent it possible inserts and proper shoe gear.
Bunions develop due to a muscle imbalance of the foot. Correcting the bunion surgically will not prevent recurrence. The muscle imbalance needs to be addressed. I recommend you see a foot and ankle surgeon (podiatrist) to discuss options to address the muscle imbalance
One of the most important things to do is to pick the right shoes to wear. Generally, you will need a shoe that has a stiff sole and not narrow at the toe box. After surgery, it is best to be fitted for custom orthotics to help control the biomechanics of your feet to prevent recurrence.
Bunions are technically caused by a combination of poor shoe gear, genetics, and mechanical dysfunction of the foot (particularly pronation and flat foot). When I do bunion surgery, I will, as often as possible, include an implant to prevent pronation of the Subtalar Joint, which helps to prevent recurrence of the bunion in the future. If your surgeon did not do this, the best ways to prevent recurrence of, or formation of a new bunion is to wear mostly flat shoes-stay away from high heels and shoes that taper in the toe box (you need a rounded or squared off toe box). Also, using appropriate (NOT Dr Scholl or The Good Feet Store) orthotics in your shoes can significantly help to prevent the formation of bunions by maintaining proper mechanical control of your foot and ankle.