Do high heels cause bunions?

High heels may contribute to the development of bunions, however there’s uncertainty about the initial cause of bunions. Wearing poorly-fitting shoes tends to make foot problems worse, but it doesn’t necessarily cause foot problems.

High heeled shoes typically have a narrow toe box that puts pressure on the toe and pushes the toe over to the side. Flat shoes can be problematic too, as they’re narrow and do not provide arch support.

For some people, bunions are caused by the way they walk – rather than the shoes they wear. Our walk, or our gait, is influenced by many factors, some of which are inherited. For example, people who have flat feet are more likely to develop bunions as are those with very flexible or hyper-mobile joints. These conditions pre-dispose the foot to developing a bunion and associated conditions such as arthritis.

Women are also more likely to develop bunions, as does getting older.
A bunion (also known as hallux valgus) is a misalignment of the knuckle of the big toe. It can also form at the base of your little toe – sometimes referred to a tailor's bunion or a bunionette. This misalignment causes the big toe to turn toward the smaller toes. The pressure on the second toe commences and this aggravates the pressure from the shoe (bursitis). It often creates a bump at the base of the big toe.

Bunions are not always painful, though this deformity will generally increase over time. If you’re predisposed developing bunions, high heels may speed up development

If bunion pain interferes with your daily activities and shoe modifications don't help, it's time to discuss surgical options.

A Classification System for Foot Surgery

Classification systems have been used extensively in orthopaedics for research and descriptive purposes, to classify disease and injury and to predict pathology and treatment outcomes.

A good classification system should be easily reproducible so that inter-observer reliability is high. With the advent of minimally invasive techniques, accurate pre-planning for foot surgery has become even more important. In particular, obtaining consent has become an increasing burden for surgeons.

Documenting each bone to be operated on is a time-consuming process and there simply isn’t enough space on a standard hospital consent form to include this information.

I’m proposing the following classification system to simplify this process and increase the accuracy of surgery planning.