A bunion (hallux valgus) is when the big toe angles towards the smaller toes, creating a bony bump on the inner side of the foot at the base of the big toe. Many bunions cause few problems, but some lead to pain, rubbing and difficulty finding comfortable shoes. Non-surgical care can ease symptoms, but it does not reliably straighten the toe, and surgery is an option for persistent pain.
Also known as bunion, hallux valgus, hallux abducto valgus, HAV
Symptoms
- A bony bump on the inner side of the foot at the base of the big toe
- The big toe angling towards, or overlapping, the second toe
- Pain, redness or rubbing over the bump, especially in shoes
- Hard skin or corns where toes press together or under the ball of the foot
- Difficulty finding shoes that fit comfortably
Causes and risk factors
- Family history, which is a strong predictor
- Being female
- Increasing age
- Footwear that squeezes the toes, such as narrow or high-heeled shoes, may contribute
- Foot shape and joint flexibility, and inflammatory conditions such as rheumatoid arthritis
What the evidence says helps
- Non-surgical treatments such as orthoses, splints, manual therapy and exercises are more likely to reduce pain than to change the angle of the big toe, and the overall certainty of evidence is low.2
- In a randomised trial, foot orthoses gave short-term pain relief compared with no treatment, but surgery gave better results at one year.3
- Current evidence does not show that orthotics reliably change the bunion angle on X-ray or stop it progressing, although they may ease symptoms.4
- Foot exercises, especially when combined with taping or an orthosis, may reduce pain and the toe angle in mild to moderate bunions, but the trials are small.5
- A dynamic bunion splint reduced pain during walking in one randomised trial but did not change the toe position.6
- Surgery (osteotomy) is an effective option for painful bunions that do not settle, and is usually considered when pain affects daily life.3
Things you can try at home
- Choose shoes with a wide, deep toe box and a low heel
- Use a gel bunion pad or toe spacer if it makes shoes more comfortable
- Try simple foot exercises, such as spreading the toes and gently drawing the big toe away from the others
- Look after skin and nails, and seek help for painful corns or hard skin
- Pain relief, such as paracetamol, may help short term: check with a pharmacist
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A hot, red, swollen big toe joint that comes on suddenly (possible gout or infection): contact your GP or NHS 111 the same day
- Redness and swelling with a high temperature or feeling unwell: contact NHS 111 or your GP urgently
- An open wound, ulcer or blister over the bunion that is not healing: see your GP or podiatrist promptly
- If you have diabetes and notice a wound, colour change, swelling or heat in your foot: seek same-day advice from your GP, diabetes foot team or NHS 111
- Severe pain after an injury with inability to walk: go to an urgent treatment centre or A&E
How Apollo can help
Our podiatrist assesses your foot, skin, footwear and walking pattern, and helps manage corns, hard skin and pressure areas. We give honest advice about what non-surgical care can and cannot achieve, and provide footwear advice, exercise and padding or orthotics where they are likely to help comfort. If surgery is on the cards, we can refer you on and support you with prehab and post-operative rehabilitation.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can bunions be corrected without surgery?
Current evidence suggests non-surgical treatments are more likely to ease pain than to straighten the big toe. Orthotics, splints and exercises may make you more comfortable, but surgery is the only reliable way to change the position of the joint.
Do toe spacers or bunion correctors work?
Some small studies suggest splints and toe spacers can reduce pain, and a few report small changes in angle. However, the evidence is low quality and they have not been shown to permanently correct a bunion.
When should I consider bunion surgery?
Surgery is usually considered when pain persists despite footwear changes and other measures, and affects your daily life. It is not normally recommended for appearance alone. Your GP can refer you to discuss the options.
References
- Nix S, Smith M, Vicenzino B (2010). Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. Journal of Foot and Ankle Research. View source
- Hurn SE, et al. (2021). Effectiveness of nonsurgical interventions for hallux valgus: a systematic review and meta-analysis. Arthritis Care & Research. View source
- Torkki M, et al. (2001). Surgery vs orthosis vs watchful waiting for hallux valgus: a randomized controlled trial. JAMA. View source
- DeHeer PA, et al. (2024). Orthoses effect on radiographic measurements of hallux abducto valgus: a systematic review. Journal of the American Podiatric Medical Association. View source
- Zhu ZT, et al. (2025). Effects of exercise combined with external support on hallux valgus angle and pain: a systematic review and network meta-analysis. Foot and Ankle Surgery. View source
- Plaass C, et al. (2020). Short term results of dynamic splinting for hallux valgus – a prospective randomized study. Foot and Ankle Surgery. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
