Bunions and Hallux Valgus

Author: Judy Flegel

Feb 6, 2019

wiki Photo

Do your toes look like this?  Hallux valgus is the drifting of the first toe towards the smaller toes.  Although most people think it is a result of poor footwear choice (wearing narrow, pointed and /or high heeled shoes) it is actually more a result of family history and predisposition.  Hallux valgus is often accompanied by a bunion. The bunion is the bony prominence on the side of the big toe joint; hallux valgus is the altered position of the great toe.


Hallux valgus is a common foot deformity that we see at Pedorthics London.  Often we see it associated with increased mobility in the forefoot. Because the first toe and the first toe joint (1st metatarsal - phalangeal joint) are so important during the push off phase of walking and running, this increased mobility results in instability and poor mechanics.  This can lead to the development or progression of the deformity.

Surprisingly, many people with hallux valgus and bunion may have no symptoms other than discomfort in shoes that are too tight or too narrow.  Others may have pain, redness and sometimes swelling at the joint. Push off during walking can cause discomfort.

Pedorthic treatment options are non-surgical options that may include:

  • custom foot orthotics to control underlying poor foot mechanics,

  • hallux valgus soft splints to wear functionally (while walking) to help improve toe alignment,

  • hallux valgus rigid splints to wear at night or post surgically,

  • advice regarding appropriate shoe features and types to reduce pressure and improve walking mechanics,

  • footwear modifications such as rocker soles/stiffening to aid push off and reduce pressure over the bunion area.

Interventions recommended will depend on the severity of the deformity.  Hallux valgus that is still flexible (can passively straighten the toe) will generally have better response to treatment. Keep in mind that these conservative interventions can ease pain and help slow progression of the deformity, but not fully correct it.

The biggest Pedorthic challenge in treating hallux valgus and bunion problems is helping our clients to accept a change in shoe style!

photo source: European Foot Institute