What is it? A bunion, known medically as hallux valgus, is a common and progressive foot deformity that affects the joint at the base of the big toe. Contrary to popular belief, a bunion is not merely a 'bony lump' that grows on the side of the toe. Instead, it is a complex structural change in the foot's anatomy. The long bone of the foot (the first metatarsal) starts to move inwards, forcing the big toe to lean outwards, towards the second toe.

This shift in bone alignment creates a prominent, often painful, bony prominence or 'bump' on the side of the big toe joint. Over time, the angle between the big toe and the first metatarsal becomes increasingly severe. Bunions are a very common reason for seeking private podiatry care in the UK and are much more prevalent in women.

What are the symptoms?

• The Bump: A prominent bony bump on the inside edge of the big toe joint.
• Big Toe Angulation: The big toe is visibly pointing towards the other toes, sometimes even overlapping or crowding them (creating 'hammer toes').
• Pain: The bump can become red, swollen, warm, and tender to the touch, especially after wearing tight or high-heeled shoes.
• Stiffness: Reduced range of motion or stiffness in the big toe joint (metatarsophalangeal joint).
• Corns and Calluses: Hard skin often forms over the prominent bump, between the big toe and the second toe, and under the ball of the foot due to shifted pressure.
• Shoe Difficulties: Finding comfortable footwear can become a significant challenge as the deformity worsens.

What causes it? Bunions are rarely caused by a single factor, but rather a combination of heredity and lifestyle:

• Genetics: This is the most significant factor. You do not inherit the bunion itself, but rather an inherited foot structure (like flat feet or unstable arches) that is prone to developing one.
• Footwear: While not the sole cause, wearing tight, narrow, or high-heeled shoes can significantly accelerate the development of a bunion in someone who is already genetically predisposed. They also cause immediate irritation to the bony bump.
• Foot Type: Having flat feet or loose, flexible joints increases the risk.
• Medical Conditions: Certain inflammatory arthritic conditions, such as rheumatoid arthritis, can weaken the joint structure.
• Occupational Strain: Professions involving prolonged standing can contribute to joint instability.

What are the treatment options? It is crucial to understand that only surgery can physically "straighten" a bunion. However, the vast majority of patients find significant relief through non-surgical podiatry care, which focuses on managing symptoms and slowing progression:

• Footwear Modifications: A critical first step. We provide personalized advice on choosing footwear with a wide toe box, low heels, and good arch support to reduce irritation and joint pressure.
• Custom Orthotics: Bespoke insoles designed from a 3D scan of your feet can correct underlying biomechanical issues (like overpronation), redistributing pressure and improving how the foot functions to slow down the bunion’s progression.
• Gel Protectors and Silicone Toe Props: Custom or off-the-shelf devices like bunion shields and toe separators protect the prominent joint from rubbing and help keep the toes from crowding.
• Callus and Corn Removal: We painlessly remove the hard skin that forms over the prominent joint and under the ball of the foot, providing immediate relief.
• Corticosteroid Injections: In cases of severe, debilitating pain and inflammation within the joint, we can liaise with your GP for a targeted steroid injection to provide relief.
• Mobilisation and Splinting: (Where appropriate) Can help reduce joint stiffness.