A bunion occurs when the bone next to the big toe bulges, also called a hallux valgus. This is often the result of wearing narrow, pointed shoes, which cause the bunion to become subluxated to the outside, or a combination of bunions, where there is a bursa on the inside of the big toe that can become aseptically inflamed under the pressure of narrow shoes, and over time, the bursa wall becomes hypertrophied and locally bulges. When bunions are combined with bunions, the local bulge becomes more severe and appears to be a bone bulge, but in fact it is partly caused by inflammation of the bursa. This condition occurs most often in middle-aged and older women and has some genetic component, as well as the effect of wearing pointed leather shoes later in life. After it occurs, it can now be treated with surgery for correction.