Bunions
(Hallux Valgus) at Foot Foundation
Bunions, medically known as hallux valgus, are a progressive deformity of the big toe joint. They develop when the big toe drifts sideways toward the second toe, creating a bony bump on the inside of the foot. More than just a cosmetic concern, bunions can cause significant pain, footwear problems, and in advanced stages, arthritis in the big toe joint.
At Foot Foundation, we focus on identifying the underlying causes of bunions and providing specialist treatment to relieve pain, improve function, and help slow progression. With the right care, patients can maintain mobility and avoid long-term complications.
What are Bunions (Hallux Valgus)?
A bunion, medically termed hallux valgus, is a progressive deformity of the big toe joint (first metatarsophalangeal joint). It occurs when the big toe drifts sideways toward the second toe, while the first metatarsal bone angles outward. This creates a bony prominence on the inside of the foot.
Bunions are not simply a cosmetic issue—they represent a structural joint problem. They can cause significant pain, footwear difficulties, corns and calluses, and in advanced stages, arthritis of the big toe joint.
At Foot Foundation, we specialise in diagnosing the underlying causes of bunions, slowing their progression, and providing comprehensive management to reduce pain and improve function.
Causes & Risk Factors
Genetics – strong hereditary link, especially in those with ligamentous laxity
Foot structure – flat feet, hypermobility, or long first metatarsal bones predispose to bunions
Footwear – tight, narrow, or high-heeled shoes accelerate progression
Gender – more common in women, partly due to footwear and hormonal ligament changes
Arthritis – particularly rheumatoid arthritis, which can deform multiple joints
Occupational and activity factors – long periods of standing, running, or sport in poor footwear
Associated deformities – hammer toes, claw toes, or hallux rigidus may develop alongside bunions
Treatment at Foot Foundation
Footwear advice – recommending wider toe box shoes, cushioned midsoles, and soft uppers to reduce irritation
Custom orthotics – control pronation, offload pressure, and slow progression
Padding and strapping – protect against shoe pressure and realign the toe temporarily
Manual therapy and mobilisation – maintain joint mobility and reduce stiffness
Exercise therapy – strengthen intrinsic foot muscles and improve calf and ankle stability
Shockwave therapy – for soft tissue pain around the joint
Night splints or toe spacers – provide temporary relief but do not correct bone alignment
Referral for surgery – considered if pain is severe or footwear is intolerable, with procedures including osteotomy (bone realignment), bunionectomy, or joint fusion or replacement in advanced arthritis
Symptoms
Visible bony bump on the inside of the big toe joint
Pain, swelling, and redness around the joint
Big toe drifting toward or overlapping the second toe
Restricted movement in the big toe joint
Difficulty wearing normal footwear
Corns or calluses caused by altered pressure
Pain worsening with activity, walking, or prolonged standing
Diagnosis
At Foot Foundation, diagnosis includes:
Clinical assessment – alignment, range of motion, tenderness, callus patterns, and footwear-related irritation
Biomechanical analysis – gait assessment, pronation control, and load distribution across the forefoot
Footwear review – examining fit and style contributing to deformity
Imaging:
X-rays are used to measure bunion severity (hallux valgus angle, intermetatarsal angle) and detect arthritis
Bunions (Hallux Valgus) – FAQs
Bunions are caused by a combination of genetics, foot structure, and biomechanical stress. Narrow or high-heeled shoes accelerate the condition but are not the sole cause.
Yes. Bunions are progressive—the deformity and pain usually worsen if untreated. Early podiatry care can slow progression.
No. Conservative care cannot realign bone. However, podiatry treatment can reduce pain, improve function, and slow progression. Surgery is the only permanent correction.
Wide-fitting shoes with soft uppers, cushioning, and a roomy toe box are best. High heels and narrow shoes should be avoided.
Yes. Orthotics help by correcting pronation and reducing biomechanical stress across the big toe joint, slowing progression and relieving pain.
Surgery may be recommended when:
- Pain persists despite conservative care
- Normal footwear cannot be worn
- Deformity is severe
- Arthritis develops in the big toe joint
Yes. If underlying biomechanics are not addressed, bunions may recur. Post-surgical orthotics and footwear modification help prevent recurrence.
Yes. Bunions increase stress on the big toe joint, leading to hallux rigidus (big toe arthritis). Rheumatoid arthritis also predisposes to bunion development.
Yes. Bunions often lead to hammer toes, calluses, corns, and metatarsalgia, as the altered forefoot mechanics overload surrounding structures.
If you have persistent pain, swelling, footwear problems, or progressive deformity, early assessment helps slow progression and prevent complications.
Why Choose Foot Foundation?
Foot Foundation provides specialist bunion care, integrating podiatry and physiotherapy expertise. We use orthotics, footwear optimisation, manual therapy, and rehabilitation to manage bunions conservatively, and work closely with orthopaedic surgeons when surgery is necessary.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert bunion care is available across New Zealand.
