What is a Bunion?

A bunion (medical term: hallux valgus) is a bony prominence that forms on the inside of the foot at the base of the big toe. It develops when the first metatarsal bone drifts outward while the big toe leans inward toward the second toe, causing the joint to protrude and often become painful.

 Bunions are progressive – meaning they can worsen over time if left unmanaged.

 

What Causes Bunions?

• Bunions are caused by a combination of biomechanical, genetic, and environmental factors:

• Inherited foot structure (e.g. flat feet or hypermobile joints)

• Poor footwear – tight, narrow, or high-heeled shoes

• Repetitive pressure on the big toe joint

• Joint hypermobility or connective tissue laxity

• Arthritis, especially rheumatoid arthritis

• Muscle imbalances in the feet and legs

 

Common Signs & Symptoms

• Visible bump on the inside of the big toe joint

• Pain or tenderness over the joint

• Redness or swelling at the site

• Restricted motion of the big toe

• Development of callus or corns between toes

• Overlapping or crowding of toes

• Difficulty wearing shoes due to the shape of the foot

 

Bunion Severity Levels

• Mild – small bump, minimal pain or functional impact

• Moderate – noticeable bump with shoe-fitting issues and discomfort

• Severe – significant deformity, overlapping toes, constant pain, and joint stiffness

 

Treatment & Management Options

Bunions don’t “go away” without surgery, but non-surgical management can significantly reduce symptoms and slow progression.

 

Conservative Treatment (Non-Surgical)

1. Footwear Advice

• Choose wide-fitting shoes with a deep toe box

• Avoid pointed, high-heeled, or narrow shoes

• Use soft materials and cushioned soles

 

2. Orthotic Devices

• Custom or prefabricated orthotics can realign foot mechanics and reduce pressure on the joint

• Helps prevent worsening in flexible bunions

 

3. Padding & Shielding

• Gel or foam bunion pads can protect the area from rubbing inside shoes

 

4. Strapping or Toe Spacers

• Realigns the big toe and offloads stress (helpful for mild or early cases)

• Padding or Gel devices to cover the bunion (available at our clinic)

 

5. Anti-Inflammatory Measures

• Ice packs and topical gels (e.g., Voltaren) to reduce swelling

• Oral anti-inflammatory medications under GP guidance

 

6. Mobilisation & Strengthening Exercises

• Foot and ankle strengthening to improve joint stability

• Stretching to reduce tension in muscles pulling the toe inward

• Night splint

• Functional splint

 

Activity Modifications

• Avoid prolonged standing or walking on hard surfaces

• Use supportive footwear during exercise

• Low-impact alternatives like cycling or swimming may reduce joint irritation

 

Surgical Options (When Conservative Management Fails)

• Bunion surgery may be considered if:

• Pain is constant and limits daily activity

• Shoe fitting becomes very difficult

• There’s progression despite conservative care

 

Surgical options include:

• Realignment procedures (osteotomy)

• Joint fusion (arthrodesis)

• Minimally invasive techniques in some cases

 Your podiatrist or foot surgeon will advise on the most appropriate approach based on your age, activity level, severity, and goals.

 

Long-Term Tips to Prevent Progression

• Maintain a healthy body weight to reduce foot strain

• Choose shoes with supportive soles and adequate width

• Do regular foot strengthening and mobility exercises

• Avoid high heels or narrow footwear, especially for long periods

• Address any flat feet, hypermobility, or underlying biomechanical issues early

 

Regular Reviews

Bunions may worsen slowly over time. Regular reviews allow us to:

• Track changes

• Adjust your treatment plan

• Provide footwear guidance

• Address new or related issues like second-toe pain or callus formation

 

Got Questions?

 We’re here to help keep you walking comfortably—bunions and all.

Your step toward happy, healthy feet.

 

From your Team at Toe-tal Podiatry.