A bunion (hallux valgus) is a bony deformity at the base of the big toe, characterised by the big toe deviating towards the second toe and the first metatarsal head becoming prominent on the inner border of the foot. Bunions are extremely common, affecting an estimated one in three adults in the UK, and are more prevalent in women and in older age groups.
While bunions are a structural deformity that cannot be corrected without surgery, podiatry plays a vital role in managing symptoms, slowing progression, and maintaining function — helping many patients avoid or delay the need for an operation.
Symptoms of Bunions
Bony prominence – A visible lump or bump at the base of the big toe on the inner edge of the foot.
Pain and tenderness – Soreness over the bunion, particularly with footwear, or deeper joint pain with walking.
Swelling and redness – Inflammation of the overlying skin and soft tissue, often aggravated by shoe pressure.
Callus or bursa formation – A fluid-filled sac (bursa) or thickened skin may develop over the prominence.
Restricted big toe movement – As the deformity progresses, range of motion in the first metatarsophalangeal joint reduces.
Secondary toe deformities – The big toe can crowd the lesser toes, contributing to hammer toes or corns.
What Causes Bunions?
Bunions develop from a combination of genetic predisposition and biomechanical factors. There is no single cause, but the following are known to contribute:
Genetics – A family history of bunions significantly increases your risk. The underlying foot structure is largely inherited.
Flat feet – Excessive inward rolling of the foot increases stress on the first metatarsophalangeal joint, accelerating bunion development.
Footwear – Narrow, pointed, or high-heeled shoes do not cause bunions but can accelerate progression and increase pain.
Hypermobility – Excessive joint laxity allows the first ray to drift out of alignment more readily.
Inflammatory arthritis – Conditions such as rheumatoid arthritis can contribute to joint deformity including bunion formation.
Age – The prevalence of bunions increases with age as soft tissue support around the joint weakens.
How We Assess Bunions at Deal Podiatry
Our podiatrists carry out a thorough assessment including a clinical examination of the foot and toe alignment, assessment of joint mobility, gait analysis to identify contributing biomechanical factors, and a review of footwear. Where appropriate, we can arrange referral for X-ray to assess the degree of deformity and any associated joint changes.
Conservative Treatment Options
Orthotics – Custom or prefabricated foot orthoses correct flat feet and reduce the forces driving bunion progression. They can also help relieve pain under the forefoot.
Footwear advice – Choosing shoes with a wide, deep toe box is one of the most impactful changes you can make. We provide detailed guidance on what to look for and can recommend suitable styles.
Toe spacers and splints – Silicone toe separators placed between the big and second toes can reduce friction, relieve pressure, and provide some symptom relief, particularly during activity.
Padding and offloading – Protective padding over the bunion reduces friction and pressure from footwear, helping to manage pain and prevent skin breakdown.
Stretching and exercise – Targeted exercises can maintain range of motion in the first toe joint and strengthen the intrinsic foot muscles, helping to slow deformity progression.
Corn and callus management – Secondary skin problems caused by the bunion and altered foot mechanics are managed as part of routine podiatry care.
When Is Surgery Required?
Surgery (bunionectomy or osteotomy) is considered when conservative measures fail to adequately control pain, or when the deformity significantly affects quality of life. The decision to operate is based on symptoms, not on the size of the bunion alone. There are many different surgical techniques, and outcomes are generally good when patients are selected carefully.
If we feel surgery may be appropriate for you, we will refer you to an orthopaedic surgeon or podiatric surgeon who specialises in forefoot procedures. We can also provide pre- and post-operative care to support your recovery.
Bunions in Children and Teenagers
Juvenile hallux valgus can develop during adolescence, often with a strong family history. Surgery in young patients is generally deferred until skeletal maturity is reached. Conservative management with orthotics and footwear advice is the mainstay of treatment in this age group. Our podiatrists have experience in paediatric foot conditions and can provide appropriate assessment and guidance.
Living with a Bunion
Choose wide-fitting footwear – Look for shoes labelled 'wide' or 'extra wide' with a round or square toe box — many specialist footwear brands cater for bunion sufferers.
Avoid high heels – Heels shift body weight onto the forefoot and compress the toes, significantly worsening bunion symptoms.
Maintain a healthy weight – Reducing load through the foot lessens the forces that drive progression and pain.
Keep up with podiatry reviews – Regular appointments allow us to monitor the deformity, manage any secondary problems, and adjust your treatment plan as needed.
Related Treatments at Deal Podiatry
Deal Podiatry in Deal, Kent offers the following podiatry treatments for bunion management:
Book Your Bunion Assessment at Deal Podiatry
Bunions that are left unmanaged tend to worsen over time. Early podiatry care can slow progression, relieve pain, and help you avoid surgery. Contact Deal Podiatry in Deal, Kent for a thorough assessment and a personalised management plan.