# Bunions

> A bunion (hallux valgus) is a bony bump at the base of the big toe, with the toe leaning towards the others. Many people have no pain. Wide, low-heeled shoes, pads and simple pain relief can ease symptoms, and a podiatrist can advise on insoles, spacers or splints.

Guide in [Toes and forefoot](https://footanklelowerlimb.com.au/learn/topics/toes-and-forefoot), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/bunions
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **A bunion is a bony bump** at the base of the big toe, with the toe leaning towards the others.
- **Many people have no pain** and need no treatment.
- **Shoes come first:** wide, low-heeled shoes, with pads, spacers and simple pain relief if needed.
- **Nothing is known to stop a bunion progressing,** but care can ease symptoms.
- **See your GP or a podiatrist** if pain doesn't settle, it's getting worse, or you have diabetes.

## What is a bunion?

A bunion, known clinically as hallux valgus, is a change at the base of your big toe. The toe leans towards the other toes, and a bony bump appears on the inside of the foot [1]. Strictly, "bunion" means the inflamed tissue over that bump, but the two terms are often used to mean the same thing [1].

It's common, and becomes more common with age. Around 23% of adults aged 18–65 and 35.7% of people over 65 are affected [2], though a more recent review gave lower figures [3]. It's more common in women than in men [3].

## What causes bunions, and who gets them?

There's no single proven cause. It's most likely a mix of how your foot is built and moves, loose (hypermobile) joints and genetics [4], along with an imbalance in the muscles and ligaments of the foot [5]. Bunions tend to run in families [6]. Being female and getting older are linked with having a bunion and with it being more severe [7]. Inflammatory joint disease is also linked with them [4].

Narrow or high-heeled shoes are widely thought to contribute, but the evidence is less clear-cut than many people expect, and the part played by heel height alone is unclear [4][8]. It's fair to see shoes as a possible contributor, not a proven cause.

## What does a bunion feel like, and how is it diagnosed?

Common signs are a bony lump on the inside of the big toe joint, the toe leaning towards the second toe, and pain, stiffness and swelling in the joint [9]. The skin over the bump can be red or hard, and comfortable shoes can be hard to find [9]. Pain is usually worse when walking or wearing shoes [10], though many people have no pain at all [11].

A podiatrist or GP can make the diagnosis. It relies on the clinician's experience, because bunions vary in how they look and show up on X-ray [3]. The angle of the toe is often measured to gauge how far it has moved [12].

Other problems can look similar: gout (red, hot, swollen skin over the joint that comes and goes) [10], an inflammatory arthritis [13], or a stiff big toe joint called hallux rigidus in older adults [7]. If the joint keeps flaring up red, hot and swollen, see your GP.

## What can I do first?

Start with your shoes. Changing footwear is described as the mainstay of treatment, and many people report less discomfort once their shoes fit properly [14]. Wide-fitting, low-heeled, extra-depth shoes with soft uppers give the toe and the bump room and reduce pressure [15]. Try to avoid narrow toe boxes and high heels [14].

Low-profile bunion pads, a toe spacer and simple pain relief can also help [14]. A pharmacist can advise on pain relief such as paracetamol or ibuprofen [10]. An ice pack wrapped in a tea towel, held on the bunion for up to 5 minutes at a time, is another option [10]. Don't ice numb skin or open wounds, and stop if pain, swelling or skin soreness increases.

> [!tip] Try this
> If your bunion rubs, try a low-profile bunion pad, or a toe spacer between your big and second toes. Make sure your shoes are wide enough to take it.

A podiatrist can advise on insoles, toe spacers and toe splints [10]. Insoles may be suggested if your bunion comes with a flat foot or a stiff, sore big toe joint [15]. Non-surgical treatments are more likely to ease pain than to change the angle of the toe, and how well they work isn't certain [16].

## What if simple care isn't enough?

If pain hasn't improved after a few weeks of home care, ask your GP or a podiatrist to review it [10]. People who haven't improved with first-line care can be referred on [17]. Which option works best at this stage isn't clear yet.

If surgery is ever considered, the blood flow, feeling and movement in your foot should be checked first [5].

## Will it get worse, and what can I do about it?

A bunion often gets worse over time, but how quickly varies a lot from person to person [6]. No treatment is known to slow or stop it [18]. Comfortable shoes, pads and toe inserts ease symptoms but won't stop it advancing [6], and there isn't enough good evidence that insoles slow it down [19]. As a bunion worsens, the smaller toes, especially the second, can become deformed and painful [6].

Many people never need treatment [11]. Wide, low-heeled shoes with soft uppers remain a sensible choice for comfort [15].

## When to see a podiatrist

See your GP or a podiatrist the same day if:

- you have diabetes and notice a wound, sore, blister or colour change on your foot, because people with diabetes are more prone to foot problems that can lead to ulcers [20];
- you notice spreading redness, heat, swelling or pus in your foot, which can mean infection [14];
- after foot surgery, your calf becomes hot, swollen and painful [6].

For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

Go to the nearest emergency department if your big toe joint is suddenly hot, swollen and very painful and you have a fever and feel unwell, or if you have diabetes and a foot infection is spreading fast, with a fever and you feel very unwell.

Call 000 and ask for an ambulance if, after surgery, you have sudden severe breathlessness, chest pain that's worse when you breathe in, or you cough up blood.

See your GP soon if:

- a sore over the bunion isn't healing despite podiatry care [17];
- you have an inflammatory arthritis and your foot shape is changing a lot [14];
- the joint keeps flaring up red, hot and swollen [10].

See your GP or a podiatrist if:

- your bunion pain hasn't improved after a few weeks of home care, the bunion is getting worse, or you have diabetes [10];
- the smaller toes become painful or deformed [6].

## Common questions

### Do toe spacers or bunion splints work?

They can help with rubbing and comfort, especially if your shoes are wide enough to take them. A toe spacer sits between the big and second toes, and a splint supports the toe. They ease symptoms rather than correct the bunion, so think of them as comfort aids. A podiatrist can show you which kind suits you.

### Do exercises help bunions?

It isn't clear yet whether exercises help on their own. Non-surgical treatments seem more likely to ease pain than to change the angle of the toe, but the results are uncertain. A podiatrist or physiotherapist can suggest a sensible routine, and it can help to try it alongside better-fitting shoes.

### Can I tell a bunion from gout myself?

Not reliably. A bunion is a lasting bony bump that's sore with shoes and walking, while gout tends to bring red, hot, swollen skin over the joint that comes and goes. Both can involve the big toe joint. If it keeps flaring up, see your GP, who can confirm gout by testing fluid from the joint.

## Further reading

- [Bunions on Clindice](https://clindice.com/hallux-valgus)
- [Bunions](https://www.nhs.uk/conditions/bunions/), NHS
- [Bunions: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001231.htm), MedlinePlus
- [Bunions (Hallux Valgus) :: North Cumbria Integrated Care](https://www.ncic.nhs.uk/services/podiatry/bunions-hallux-valgus), NHS

## Sources

1. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis · Nix S, Smith M, Vicenzino B · Journal of Foot and Ankle Research · 2010. https://doi.org/10.1186/1757-1146-3-21
2. A comparative meta-analysis between chevron and scarf osteotomies in hallux valgus patients · Alqahtani TF · Frontiers in Surgery · 2025. https://doi.org/10.3389/fsurg.2025.1665319
3. Global prevalence and incidence of hallux valgus: a systematic review and meta-analysis · Cai Y, Song Y, He M et al. · Journal of Foot and Ankle Research · 2023. https://doi.org/10.1186/s13047-023-00661-9
4. Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis · Ying J, Xu Y, Bíró I et al. · International Journal of Environmental Research and Public Health · 2021. https://doi.org/10.3390/ijerph18073841
5. The treatment of hallux valgus · Wülker N, Mittag F · Deutsches Arzteblatt International · 2012. https://doi.org/10.3238/arztebl.2012.0857
6. Hallux Valgus · NHS. https://www.ruh.nhs.uk/patients/services/clinics/orthopaedic_fracture/documents/Bunion.pdf
7. Prevalence and Severity of Self-Assessed Hallux Valgus in Community-Dwelling Older South African and Flemish Individuals · Breet MC, Vanwanseele B, Menz HB et al. · Journal of Foot and Ankle Research · 2026. https://doi.org/10.1002/jfa2.70173
8. Characteristics of foot structure and footwear associated with hallux valgus: a systematic review · Nix SE, Vicenzino BT, Collins NJ et al. · Osteoarthritis and Cartilage · 2012. https://doi.org/10.1016/j.joca.2012.06.007
9. Bunions (Hallux Valgus) · NHS. https://www.ncic.nhs.uk/services/podiatry/bunions-hallux-valgus
10. Bunions · NHS · 2021. https://www.nhs.uk/conditions/bunions/
11. Hallux Valgus (Bunions) · NHS Lanarkshire · 2022. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/hallux-valgus/
12. Hallux valgus orthosis characteristics and effectiveness: a systematic review with meta-analysis · Kwan MY, Yick KL, Yip J et al. · BMJ Open · 2021. https://doi.org/10.1136/bmjopen-2020-047273
13. East Sussex MSK Community Partnership · NHS. https://eastsussexmsk.nhs.uk/wp-content/uploads/2025/10/Foot-Ankle-Triage-Guidance-2025.pdf
14. Hallux Valgus (Bunion) Commissioned Pathway - South & West · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/south-devon-torbay/musculoskeletal-joint-disorders/hallux-valgus-bunion-1
15. Bunions · Mallard A · Royal Orthopaedic Hospital. https://roh.nhs.uk/services-information/foot-and-ankle/bunions
16. Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta-Analysis · Hurn SE, Matthews BG, Munteanu SE et al. · Arthritis Care & Research · 2022. https://doi.org/10.1002/acr.24603
17. Hallux valgus · NHS. https://rightdecisions.scot.nhs.uk/referral-management-in-development/orthopaedic/foot-and-ankle/hallux-valgus/
18. Hallux valgus · Hecht PJ, Lin TJ · The Medical Clinics of North America · 2014. https://doi.org/10.1016/j.mcna.2013.10.007
19. Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review · DeHeer PA, Patel NA, Wolfe W et al. · Journal of the American Podiatric Medical Association · 2024. https://doi.org/10.7547/23-171
20. Evaluation and management of mechanical and structural nail disorders: A clinical review · Ricardo JW, Dominguez-Cherit J, Haneke E et al. · Journal of the American Academy of Dermatology · 2026. https://doi.org/10.1016/j.jaad.2025.11.025

---

This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.