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Wednesday 10 March 2021

Bunion : definition

Hallux valgus : définition, causes et traitement


A bunion is a deformity of the foot, more precisely of the first toe. This pathology can lead to complications that may require surgery. But we will see that with the right shoes, such as a pair of shoes for bunions, it is possible to avoid surgery and relieve painful bunion.


General information on bunion

Definition: What is a bunion ?

Hallux valgus is a deformity of the forefoot and more particularly of the big toe. Its joint is deviated towards the outside, resulting in a point on the inner edge of the foot.

While the tip of the big toe is deviated towards the inside of the foot and tends to push the other toes outwards.


This bony protrusion is commonly known as a "bunion".

This deformity can lead to a bunion surgical operation, but there are many alternatives before this happens. A toe deformity such as hallux valgus or even a claw toe can cause pain that can even prevent you from walking.


This medical condition is the most common deformity of the foot and ankle. In fact, it affects just under one in 10 people in France.

The disease generally appears between the ages of 40 and 50, especially in women, and is often bilateral.


Bunions are classified according to the angle of deviation of the big toe (between the metatarsal axis and that of the first phalanx):

  • Between 8 and 12°, this is the normal deviation of the bunion.
  • When the angle is less than 20°, it is usually symptomless.
  • Between 20° and 40°, it is called mild bunion. The abnormal deviation may cause symptoms.
  • When the angle is greater than 40°, it is called severe hallux valgus and can be very painful.

We will see later that this pathology evolves over time, but that solutions are possible to slow down this evolution before considering surgery, which can be painful.

Your doctor or other medical professional should test these options before considering surgery.

Schema hallux valgus


Anatomy of a bunion


What is the cause of bunion ?

Here are the main causes of bunion :

  • A hereditary and congenital factor with a first toe that is longer than the second (known as the "Egyptian" foot): this can be due to a second metatarsal that is too long or a first metatarsal that is too short.
  • Incorrect fitting with all types of shoes that place the forefoot in a position where the big toe deviates towards the outside. This is particularly the case with shoes with pointed or narrow toes, which tighten the forefoot, accentuating its triangular shape. Shoes with heels are also concerned because they make the foot slide forward and lead to an overload of a metatarsophalangeal joint. Indeed, let's not forget that the entire weight of the body rests on the feet.
  • Certain diseases can also be responsible for the appearance of this type of deformity, such as rheumatic diseases or poliomyelitis.
  • A flat foot with collapse of the arch can also lead to the formation of this type of deformity.

The consequences and pain of a bunion

  • A conflict between the bony protrusion and the shoe. This foot/shoe conflict exposes the patient to pain that can be very disabling, ranging from difficulty in putting on shoes to the inability to walk.
  • It can also lead to bursitis, which is an inflammation of a cavity that forms between the bone and the skin. In this case, redness can be observed.
  • The big toe has a very important function during propulsion, especially the first metatarsal. In the case of a deformation of this toe, it will play less or no longer its role during the support. The nearby toes will then be subjected to more pressure. We can then find hyper pressure on the middle metatarsal heads leading to the appearance of calluses (horn).
  • Claw or hammer toes can also be observed, particularly in the second toe. A claw or hammer toe will also tend to push the other toes above or below it.

The evolution of a bunion

Most feet that lead to bunions are actually very good feet, but their anatomy is more suited to walking barefoot on natural surfaces. The bunion needs to grip to function, which is impossible on hard city floors and especially in some women's shoes that prevent any toe activity due to lack of space.


This lack of activity of the toes, and more particularly the bunion, encourages the accentuation of its deformation, the deficit of the adductors and the retraction of the tendons which dislocate and become flexors. A vicious circle begins, progressively worsening over the years and often leading to irreducible and painful bunions.

Another condition may be hallux rigidus, which corresponds to arthrosis of the big toe and leads to stiffness.


How do you get rid of a bunion ?

Hallux valgus, without surgery, will not go away, however, wearing the right shoes and taking care of your feet will help you walk and live with a bunion. Most doctors will first try foot orthotics and advise you to wear a specializing pair of shoes before recommending surgery to remove the bunion.


Preventive treatment

Preventive measures are effective for an early and reducible deformity.


Choosing a good shoe for bunions

Good footwear often relieves rubbing pain.

Podexpert has selected a whole range of medical bunion shoes that will help you relieve the pain caused by your bunion rubbing against the upper of your shoe. We assure you that wearing shoes adapted to this type of deformity will bring you unprecedented relief.


There are many criteria to consider when choosing your shoes if you suffer from bunion:

  • A wide fit. More volume in the forefoot will help preserve a deformed foot and give your toes all the room they need.
  • A stretch leather insert to protect your feet like a second skin while maintaining its technical and aesthetic performance.
  • No inner seam in front of the bunion to avoid any conflict between the foot and the shoe.
  • A removable insole to adjust the volume if necessary or to easily accommodate your orthopedic insoles.
  • A rear heel counter for long-lasting, comfortable support of the heel and therefore good stability.
  • A heel that is not too high to avoid transferring a large portion of the weight to the forefoot and thus causing hyper-pressure.

More information on the subject: Which are the best shoes for bunion ?


Selection Bunion



Other treatments to relieve the pain of a bunion

  • Maintenance of muscle flexibility

To be done with a physiotherapist and/or at home.

  • Correction of associated static disorders with orthopedic inserts

Remember to choose shoes with removable inserts to accommodate your orthopedic inserts, which must be made by a health professional such as a pedorthist, podiatrist or orthopedist.

  • Wearing a night splint.

This type of brace will help straighten the first toe at night.

  • Analgesic support with an adhesive bandage or orthosis

Discover also our range of silicone foot protectors to relieve your pain. The main one is the Pedisoft bunion guard. It will provide immediate and long-lasting relief from pain related to bunion.

Indeed, this one is made of silicone, which allows to have a soft and durable protection. Thanks to the "memory" effect, it adapts perfectly to the contours of each part of the foot without slipping and returns to its initial shape immediately after use.

If you have pain under the forefoot, you can turn to the cushioning pads.


Chirurgical treatment

Bunions, without surgical operation, will not go away, however, wearing the right shoes and taking care of your feet will help you walk and live with a bunion. Most doctors will first try foot orthotics and advise you to wear a suitable pair of shoes before recommending surgery to remove the foot bunion.


However, if foot surgery becomes necessary to relieve your pain, here are some things to be aware of:


Many people do not require a general anesthetic during surgery, a local anesthetic is often sufficient for this surgical procedure.


The most common types of bunion removal procedures include osteotomy, exostectomy and arthrodesis. Your surgeon will know which one is right for you and which one is safe.

  • In an osteotomy, the orthopedic surgeon cuts the joint of your big toe and realigns it to its normal position.
  • In an exostectomy, the surgeon removes the bunion from the joint without performing an alignment.
  • In an arthrodesis, your surgeon will replace the damaged joint with screws or metal plates to correct the deformity.

In the case of an outpatient procedure, you will be discharged from the hospital or clinic and returned home the same evening.


Recovery time may take several weeks and will depend on the medical technique used and any post-operative complications.


Author : Philippe Vesin - Pedorthist

bunion podexpert
What the best shoes for bunion ?
Wearing the right shoe is very important when you have a bunion. Here are the keys to finding the right bunion shoe. Read more
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Hallux valgus is a painful deformity of the foot located on the big toe. Although wearing a specific shoe can slow down its evolution, surgery is often unavoidable. Read more
Causes of the bunion
Causes of the bunion
At present, medicine is still unable to determine the exact causes of hallux valgus. However, this deformity of the forefoot seems to be favored by the wearing of unsuitable shoes, especially high heels. Read more
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Hallux valgus is a common foot condition in which the phalanx of the first toe deviates outward. It causes a "bunion" on the metatarsal and is painful: inflammatory symptoms, painful toes, poor footing, arthritis, etc. Read more
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