Are bunions hereditary?

If you have seen your parents or grandparents deal with painful bunions, you may wonder if you will have them too. Many people worry about the link between genetics and bunions. This is especially true for those who have seen family members have bunion surgery or suffer from foot pain.

Podiatrist Ian Yarger, DMP, a podiatrist at Mount Nittany Health, shares an expert perspective on the hereditary nature of bunions.

What are bunions, and why do they form?

A bunion, medically known as hallux valgus, is a bony bump that forms at the base of the big toe. It occurs when the big toe joint (metatarsophalangeal joint) becomes misaligned, causing the toe to angle toward the second toe while the joint itself protrudes outward.

Constant pressure gradually pushes the big toe joint out of its normal position, creating bunions and altering how weight distributes across the foot. This can also cause problems like hammertoes, calluses and ongoing foot pain.

This progressive deformity often causes pain, swelling and redness around the joint. As bunions worsen, they can make walking difficult and create challenges in finding comfortable shoes. According to the Journal of Foot and Ankle Research, about 23% of adults ages 18 to 65 and more than 35% of those over 65 have bunions, making them one of the most common foot conditions.

“Several factors influence bunion development, including genetics, foot structure, weight-bearing activities and footwear choices,” says Dr. Yarger. “Some individuals begin developing a bunion at a relatively young age, often due to anatomical factors rather than lifestyle. In these cases, the role of shoe gear or activity level is minimal.”

“However, when bunions develop later in life, footwear tends to play a more significant role,” he continues. “Regularly wearing shoes that crowd the forefoot and push the big toe toward the second toe can gradually alter the toe’s alignment. Over time, this pressure can lead to a bunion deformity by affecting the pull of the tendons around the joint.”

The genetic connection to bunions

Research strongly suggests that bunions do have a hereditary component. Studies have found that about 63% of bunions appear to run in families, indicating a significant genetic influence. Unlike eye color or blood type, people don’t directly inherit bunions.

What you actually inherit is your foot structure and mechanics. “Bunions themselves are not always painful, but they can become uncomfortable due to pressure from shoes or repeated stress during daily activities,” says Dr. Yarger. “Certain foot shapes — such as having a long first metatarsal or a flatfoot — can increase the likelihood of developing a bunion later in life.”

It’s important to understand that having a family history of bunions doesn’t guarantee you’ll develop them. Instead, it increases your chances. Many people with a strong family history do not develop bunions, as other factors play a role in determining whether genetics leads to a bunion.

Beyond genetics: other factors that cause bunions

While genetics sets the stage, several non-genetic factors significantly influence bunion development.

Footwear choices are the most influential environmental factor. Shoes with narrow toe boxes or high heels compress the toes and place excessive pressure on the big toe joint. Over time, this pressure can accelerate or trigger bunion formation in someone with a genetic predisposition.

Your gait (walking pattern) also affects bunion development. Some biomechanical issues can cause problems. One example is overpronation. This happens when the foot rolls too far inward. Overpronation puts extra stress on the big toe joint, which can lead to bunions.

Various medical conditions can also contribute to bunion development. Inflammatory conditions, such as rheumatoid arthritis, can weaken joint structures, while disorders affecting nerves and muscles may alter foot mechanics, promoting bunion formation.

Assessing your risk for bunions

If bunions run in your family, you should watch for early warning signs:

• Persistent big toe joint pain
• Gradual widening of the forefoot
• Difficulty finding comfortable shoes
• Your big toe is starting to angle toward your second toe
• Recurring calluses on the inside of your big toes or under the ball of your foot

Self-assessment can involve looking at your foot shape. You can compare it to family members with bunions. You can also check if your big toe angles toward your second toe, even if it doesn’t hurt.

Early evaluation by a foot doctor is valuable when you have a family history of bunions. A podiatrist or foot specialist can check your foot structure, walking style and alignment. They will assess your risk level and suggest ways to prevent problems before they start.

Bunion prevention

You can take several proactive steps to prevent or slow the development of bunions, even if you have a genetic predisposition.

Proper footwear is your first line of defense. “The best way to reduce the risk of developing bunion deformity is to wear comfortable, supportive shoe gear with adequate space in the toe box and arch support if needed,” says Dr. Yarger. “Use of well-made, comfortable shoe gear is beneficial throughout the patient’s life, starting in childhood.”

Targeted exercises can help maintain proper toe alignment and strengthen supporting muscles. Simple exercises like toe spreads, picking up marbles with your toes and stretching your feet help keep your joints moving and aligned.

Custom orthotics or over-the-counter arch supports can provide stability for your feet and improve weight distribution across your foot. These devices help control excessive pronation and support flat feet or high arches, potentially preventing joint misalignment that can lead to bunions.

“For some people, especially those with a strong family history, bunion development may be unavoidable despite early intervention or careful footwear choices,” says Dr. Yarger. “That said, wearing supportive shoes with good arch support and a wide toe box that allows the forefoot to spread naturally can help lower the long-term risk.”

Treatment options for bunions

If you’ve already developed a bunion, several treatment approaches can help manage symptoms and slow progression. Conservative treatments focus on relieving pain and preventing worsening, including:

• Padding and taping the bunion to reduce pressure
• Apply ice to reduce swelling and inflammation
• Over-the-counter pain relievers
• Bunion splints or spacers to improve alignment
• Physical therapy to maintain joint mobility

“While non-surgical options can help manage symptoms, they do not stop or reverse the progression of a bunion,” says Dr. Yarger. “Fortunately, recent advances in bunion surgery have led to more aesthetically pleasing and predictable outcomes, with a reduced risk of recurrence.”

Surgical intervention becomes an option when bunions cause significant pain that limits daily activities or when conservative measures fail to provide relief. Modern bunion strategies range from minimally invasive procedures to more complex reconstructions, depending on the severity of the deformity.

“Surgical correction of a painful bunion deformity is one of my favorite procedures to perform because of the meaningful impact it can have on a patient’s quality of life,” he notes. “It often allows individuals to return to or even increase their level of physical activity with improved comfort and function.”

“As of 2025, bunion surgery has advanced significantly — it is now more aesthetically refined, less painful and more consistent in its results,” says Dr. Yarger. “Recovery times have shortened, and the risk of recurrence has decreased considerably.”

“That said, I do not recommend bunion surgery for cosmetic purposes alone,” he adds. “I typically reserve surgical intervention for patients experiencing pain that limits their daily activities or prevents them from wearing appropriate footwear needed to stay active and engaged in the things they enjoy.”

Genetics can increase the chance of developing bunions. However, your lifestyle choices and early treatment play a significant role in whether you will develop them, just like your family. Understanding your risk factors and taking proactive steps can help you maintain healthy, pain-free feet for years.

Concerned about your risk of developing bunions? Schedule a consultation with our foot and ankle specialist at Mount Nittany Health to evaluate your foot structure and recommend the best solution for your feet.