A bunion, also known as hallux valgus, is a foot deformity involving an abnormal position of the big toe in relation to the other toes. A characteristic symptom is the deviation of the big toe towards the other toes and the development of a bony prominence at the base of the big toe, on the inner side of the foot.

In the case of bunions, the alignment of the first metatarsophalangeal joint becomes disrupted. The first metatarsal bone may shift towards the medial side of the foot, while the big toe becomes misaligned and angles towards the other toes. These changes may be accompanied by altered positioning of the head of the first metatarsal bone, overload of the forefoot, and changes in gait biomechanics. In some cases, the deformity may also lead to reduced joint mobility and pain.

The development of bunions is usually associated with several contributing factors acting together. Anatomical predisposition, meaning the individual structure of the foot, and genetic factors can play an important role. If bunions occur in close family members, the risk of developing this deformity may be higher.

• wearing shoes that are too tight, especially those with a narrow toe box,
• frequent use of high-heeled shoes,
• foot biomechanics disorders, such as transverse flatfoot,
• excessive body weight increasing the load on the feet,
• previous injuries,
• hormonal changes affecting tissue elasticity,
• inflammatory joint diseases, such as rheumatoid arthritis.

Wearing high heels or a specific type of footwear does not mean that everyone will develop bunions. The development of this deformity is influenced by many individual factors.

The first symptoms of bunions may be subtle and easy to overlook. Initially, a patient may notice only a change in the appearance of the foot or mild discomfort while walking. Over time, however, the deformity may progress.

The most common symptoms of bunions include:

• deviation of the big toe towards the other toes,
• thickening at the base of the big toe,
• pain around the first metatarsophalangeal joint,
• redness and inflammation at the site of the deformity,
• development of calluses and skin thickening,
• difficulty finding comfortable footwear,
• pain that worsens during prolonged walking or standing.

Advanced bunions may cause overload of the other toes, changes in walking patterns, and limited mobility of the big toe. This affects not only movement comfort but also the function of the entire musculoskeletal system.

Bunion prevention is particularly important for people with a genetic predisposition or those who notice early changes in the alignment of the big toe. Proper foot care and attention to daily habits can help reduce overload and support proper foot function.

One of the key elements of prevention is wearing properly fitted footwear. Shoes should provide enough space for the toes, avoid pressure on the forefoot, and allow a natural walking pattern. It is worth limiting frequent use of high-heeled shoes, as they change the distribution of weight and increase pressure on the metatarsal area.

The following may also be helpful in the prevention of hallux valgus (bunions):

• Exercises to improve big toe mobility: they help maintain proper mobility of the metatarsophalangeal joint and prevent movement restrictions, supporting proper foot function during walking.
• Exercises to strengthen foot muscles: strengthening the intrinsic foot muscles (e.g., the abductor hallucis muscle) and structures supporting the longitudinal and transverse arches of the foot may improve foot stability. This is particularly important because hallux valgus is often associated with abnormal foot alignment, including flatfoot.
• Foot massage or rolling the foot with a ball: this may help reduce muscle and plantar fascia tension and relieve pain associated with overloading of foot structures.
• Monitoring big toe alignment during daily movement: developing awareness of foot positioning and working on a proper walking pattern may reduce overload and support maintaining proper foot function. It is worth paying attention to excessive pronation, meaning excessive inward rolling of the foot, which may affect the biomechanics of the lower limb.

The selection of appropriate exercises should be discussed with an orthopedic physiotherapist. If there are structural abnormalities of the foot, a specialist may recommend the use of orthopedic insoles or custom-fitted insoles tailored to the patient’s individual needs.

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Treatment methods for bunions are selected individually and depend primarily on the severity of the deformity and the intensity of symptoms. In the early stages, conservative treatment is often used. Its main goal is to reduce pain, improve daily comfort, and limit factors that worsen symptoms. It may include, among other methods, the removal of calluses and skin thickening, selection of appropriate footwear, the use of orthopedic insoles, or exercises to improve foot function.

Anti-inflammatory medications may be used in cases of increased pain; however, they should be selected according to the patient’s individual situation.

In more advanced cases, when the deformity significantly affects daily functioning, surgical treatment may be considered.

It is not worth waiting until bunions start interfering with daily activities. A consultation with a podologist should be considered as soon as you notice the first signs of irritation, corns, or other symptoms related to the developing big toe deformity. A podologist can help relieve symptoms, reduce pressure on painful areas, and recommend appropriate foot care. However, if the severity of the deformity requires further evaluation, they will refer you to an orthopedist, who will assess whether surgical treatment is the best option in a given case.

1. Durlacher, Lewis. A treatise on corns, bunions, the diseases of nails, and the general management of the feet. Lea & Blanchard, 1845.
2. Piqué-Vidal, Carlos, María T. Solé, and Jaume Antich. “Hallux valgus inheritance: pedigree research in 350 patients with bunion deformity.” The Journal of foot and ankle surgery 46.3 (2007): 149-154.
3. Ferrari, Jill, Julian PT Higgins, and Trevor D. Prior. “Interventions for treating hallux valgus (abductovalgus) and bunions.” Cochrane Database of Systematic Reviews 1 (2004).