Overview
A bunion (hallux valgus) is a bony bump that forms at the base of the big toe, pushing it towards the other toes. The joint becomes deformed, painful, and sometimes inflamed. Bunions develop slowly and worsen over time if not addressed.
How common is it?
Bunions affect around 1 in 3 adults in Western countries, being more common in women. They become more frequent with age.
Causes and risk factors
Bunions develop when the forces of walking and weight bearing are unevenly distributed across the foot joints, causing the big toe joint to tilt outward gradually.
Common risk factors
- Wearing narrow, pointed, or high-heeled footwear over many years
- Strong family history (foot shape is inherited)
- Inflammatory arthritis such as rheumatoid arthritis
- Flat feet or flexible foot joints
- Previous foot injury
- Female sex
Symptoms
- Visible bony bump at the base of the big toe
- Pain or soreness at the joint, especially in shoes
- Redness and swelling around the joint
- Restricted movement of the big toe
- Calluses where toes rub against each other
- Difficulty finding comfortable footwear
When to see a doctor
See a doctor or podiatrist if bunion pain is preventing normal activities, is not relieved by wider shoes, or if the area becomes very red, hot, or swollen (which could indicate joint infection or gout).
Diagnosis
Diagnosis is clinical based on examination. X-rays confirm the degree of joint deviation and help plan surgery if needed.
Treatments
Footwear changes
Wide-fitting shoes with a broad toe box and low heels are the first step. This does not reverse the deformity but significantly reduces pain.
Orthotics and padding
Toe spacers, bunion shields, and insoles redistribute pressure and provide symptomatic relief.
Surgery (bunionectomy)
For painful bunions that do not respond to conservative measures. The bone is realigned and held in place with screws. Recovery takes 6 to 12 weeks.
Self-care and lifestyle
- Choose shoes with wide toe boxes and avoid heels over 5cm
- Foot exercises strengthen the muscles that support the toe joint
- Ice packs reduce pain and swelling after activity
- Maintain healthy weight to reduce load on foot joints
Prevention
Wearing properly fitting shoes throughout life, especially in childhood and adolescence, reduces but does not eliminate bunion risk.