Have you just been diagnosed with hallux valgus and you are wondering about the treatment options available, how bunions can be corrected without or without surgery.
What rehabilitation and natural treatments are available. The recommendations given apply to whether you have a mild or a more severe form of hallux valgus.
I write this article based on my knowledge as a radiographer and my opinion based on studies published on the subject in medical literature.
Happy reading!😀Enjoy reading and feel free to ask questions in the comments or share your own experience.🙏
Last updated: April, 2025. Written by Juliet Semakula, a diagnostic radiographer.
▶️What is hallux valgus (bunion).
Hallux valgus is a common forefoot deformity that can cause pain in the foot leading to difficulty in mobilising for some people.
It usually affects the big toe bone at the first metatarsophalangeal joint of the foot.
The image below shows a clinical photography and x-ray demonstrating a hallux valgus deformity of a foot.
Image showing a hallux valgus deformity of a foot (Lewis, 2025)
The pressure from the big toe can force the second toe out of alignment, sometimes overlapping with the third toe.
▶️What causes a Hallux valgus also known as bunion deformity?
The exact causes of hallux valgus deformity are still unknown, but some scientific studies do give potential intrinsic and extrinsic factors believed to be the cause of hallux valgus deformity.
Potential causes of hallux valgus (Perera,2011)
Explained more in detail.
⚫Heredity or genetics play some role in bunion deformity: it is believed that inherited foot types make individuals more prone to developing bunion deformity.
⚫Anatomy foot types such as short first metatarsal can predispose individuals to bunions deformity.
⚫When you have inflammation conditions such as rheumatoid arthritis, usually causes joint damage and can contribute to the development of bunion deformity (Ying,2021)
⚫Bunion deformity has been related to age, A biomechanical study in elderly patients showed that changes in posture, joint kinematics, and plantar pressure are associated with a greater risk of hallux valgus.
⚫Some injuries and certain sports activities can cause joint damage and contribute to the development of bunions.
⚫If you wear shoes that are too tight, narrow or have a pointed toe box ,this can crowd the toes and push the big toe outward contributing to a deformity.
Perera,2011
▶️How do you know it is really a hallux valgus and not something else?
Most people I have seen with bunions, whether small or large, usually complain of no symptoms apart from a prominent bump on the inside of the forefoot.
However, some patients will report pain over the prominent bump on the inside of their forefoot and under the ball of the foot near the base of the second toe.
The truth is bunion symptoms vary in severity and can occur with standing, walking or even at rest. This will also vary from individual.
To be sure that your pain and discomfort is coming from bunion deformity it will be best to seek medical examination.
When you go to the doctor, a physical examination will be done, and your doctor may request a standing x-ray of the foot to help evaluate and classify the extent of the bunion deformity.
X-ray of a foot showing a bunion (Hallux valgus) deformity.
The x-ray will be able to show the degree of big toe angulation (Hallux valgus angle) which can be measured on the x-ray.
1️⃣Mild bunion deformities are considered if the big toe angulation is <20 degrees.
2️⃣Moderate bunion deformities measure from 20-40 degrees,
3️⃣In severe bunion deformities the great toe angulation is greater than 40 degrees.
Ying,2021
⚫Usually, your big toe will reveal a prominent bump on the inside of the forefoot due to changes in the position of the metatarsal bone and great toe.
In most cases x-ray is not necessary for bunion, unless you have decided to undergo surgery
And even if the x-ray shows a severe deformity, it does not mean that you will experience more discomfort or pain.
▶️Here are some of the symptoms of bunion deformity.
Drifting of these bones will cause the big toe joint to rotate out of place (subluxate) and this usually causes:
🟠Redness and swelling along the bunion deformity which can be painful even by touching.
🟠You may have limited toe movement, which may feel stiff or difficult to move.
🟠Big toe deformity, turning inwards towards the second toe.
🟠You may develop corns, blisters and calluses when the big toe rubs against the shoe or other toes.
🟠Difficult in wearing shoes, discomfort when wearing certain tight-fitting shoes in the forefoot area.
Sometimes only one of these symptoms is present and other times all of them may be present.it will depend on the stage of development of bunion.
You will be able to find your diagnoses in your doctor’s medical report and the treatment options available.
▶️Are bunions considered a disability?
Having bunions is not considered a disability here in the United Kingdom and it is not listed as a disability by the NHS.
But we all know that having bunions can be a significant impairment in some people especially when they cause pain, discomfort and limitations.
These limitations can potentially make someone eligible for disability benefits.
This will depend on the severity of your condition and how it affects your ability to perform daily activities.
These can potentially make you eligible here in the UK, am not sure for other countries.
▶️At what age can a bunion develop?
While bunions are most common among adult women, they also can occur in young teenagers.
Teenage girls are three times more likely than boys to get bunions deformity. Females are over twice as likely to develop hallux valgus compared to males (30% females, 13% males)
What age do kids get bunions?
Yes, some children can have bunion deformity which is referred to as juvenile hallux valgus for the under 18-year-olds.
8% of people under 18 years old have bunion,15% being girls and 6 % being boys (Ying,2021)
Bunions are more common around 30 to 45 years old.
🟦Approximately 23% of adults aged between 18 and 65 years have hallux valgus, this increases to 36% among people aged over 65 years (Lewis,2024)
The risk of hallux valgus increases with age, women having a higher prevalence than men (Ying,2021)
1 in 5 adults over the age of 50 years over a 7-year period are more likely to get bunion (Menz 2023)
All these numbers can provide perspective on the occurrence of hallux valgus at young age and adult age is quite common.
▶️How do you fix or treat bunion (hallux valgus) deformity?
Regardless of the specific type and degree of deformity you have got, it is primarily the discomfort and individual expectations that will guide the treatment approach.
You can not get rid of bunions or stop them from getting worse yourself but there are things you can do to improve bunions and ease any pain and discomfort.
For those who are greatly bothered by their bunion and wish to seek treatment in such cases, there are two types of treatment options, conservative and surgical management.
According to suggestions given by the American college of foot and ankle surgeons, it is advised to consider conservative management before surgery.
1️⃣Conservative management
The main goal usually your physiotherapy or doctor focus on when treating bunion is to see that your:
🟡Pain is alleviated.
🟡Reducing the angle of deformity.
🟡Achieving improved functionality.
Many studies have evaluated the impact of different conservative treatments on these three restrictions.
And they do recommend shoe modification, orthoses, and splints to be the most frequently used conservative treatment options.
Here are some of the conclusions reached by the most recent publication on these treatments.
🔵Shoe modification, which is wearing wide, low-heeled, or specially altered shoes with increased medial pocket for the first metatarsophalangeal joint to minimize deforming forces is encouraged.
🔵Orthoses, which are used to improve foot mechanics such as reducing abnormal subtalar, joint pronation and preventing abnormal forces applied to the foot.
🔵It is hoped that orthoses might prevent deterioration of the hallux valgus angle and help relieve pain by improving joint function.
🔵Orthoses have been shown to prevent the progression of hallux valgus deformity.
🔵Splints could also be used to place the toe in a corrected position in the hope of enabling soft tissue adaptation and delaying rupture of the medial joint capsule and collateral ligament
I have seen people with bunions use night splints which realign the hallux while sleeping, placing wedges between the big and second toe and strap them together with adhesive.
However, night splints were seen as ineffective in reducing pain associated with hallux valgus deformity in one small, randomised trial (Sherman 1984)
Studies of using splinting for hallux valgus are limited by their small sample sizes and risk of bias should be noted.
Here are some steps you can take to help ease pain and discomfort at home advised on the national health services in England.
🔵Wear wide shoes with a low heel and soft sole if you can.
🔵You can apply cold ice wrapped in a towel to the bunion every 5 minutes to help calm pain.
🔵You can try using bunion pads to help stop rubbing on a bunion, you can buy these ones in any pharmacies, or you can have a look on Amazon for some simples.
🔵Your doctor may prescribe paracetamol or something else to help with pain.
🔵If you are over size try to lose weight, to help with pressure on your foot.
▶️How to improve bunion deformity without surgery: Physical therapy exercises that can help:
There is no evidence to suggest that exercise further deformity, however some patients have found the following exercises helpful with pain and toe mobility.
🟣Toe stretches: you can grasp the big toe and bend it upwards, downwards, and in a circular motion, holding each position for a few seconds.
🟣Toe spreading focuses on the big toe by spreading outwards.
🟣Big toe circle: you can gently rotate the big toe in a circular motion.
🟣You can stretch the calf muscle to reduce pressure on the front of the foot.
🟣You can place a towel under the foot and use toes to scrunch it.
Some of the big toe exercises to help with your pain and discomfort.
I have also seen some patients use specialist devices that loop around the big toe to provide stretching.
Spread your feet so that the toe is ‘straightened’ and hold for several minutes. Repeat several times.
Image from NHS gates head health.
However, exercises do not correct the deformity, but they can help reduce pain and toe mobility.
▶️ When should you consult a doctor for bunions?
If your pain from bunion has not improved and it is stopping you from doing normal activities and you have other conditions such as diabetes, foot problems can be serious.
You may need to discuss your foot problems with a healthcare professional, you can speak to a doctor, physiotherapist or a foot expert.
When you go to the doctor you will be asked questions and examined to confirm or rule out the diagnosis of bunion.
You will be informed of different treatment options for bunion deformity in your case.
Sometimes they can refer you to a podiatrist or an orthopaedic surgeon if it is necessary.
2️⃣Surgical management
There are several types of hallux valgus surgeries often performed under local anaesthesia = without general anaesthesia.
Here are some of them, I see every day in radiology interventional.
⚫ Minimally invasive techniques under x-ray.
⚫Osteotomy: Surgical osteotomy is seen as an effective treatment for painful hallux valgus (Torkki, 2001)
⚫ Percutaneous technique under x-ray guided.
A recent study based on Hospital Episodes Statistics (HES) in England over a ten-year period from 1999 to 2019 showed that an average of 10,157 hallux valgus surgeries is carried out every year (Lisacek-kiosoglous,2021)
So, this is very common and here is some information to help you determine the importance of undergoing surgery in your case considering your current pain and discomfort and expectations.
A study that followed 209 people between the ages of 48 years,93% women who had painful bunion for over a year.
They were randomly assigned to three different groups
1️⃣Some underwent osteotomy surgery
2️⃣Some wore custom orthotics
3️⃣Some did not have surgery or wore orthotics.
Torkki 2001
Here is how these people progressed:
♦️4 people who had not opted for surgery or orthotics, after one year due to significant pain decided to have surgery.
♦️After 6 months,for those who had surgery, walking pain had decreased compared to the non interventional group.
♦️At 1 year walking pain had decreased more in those who had surgery.
▶️What can be possible complications of bunion surgery?
Another study that followed patients after several months and two years of surgery, identified hallux valgus recurrence in ¼ of patients who had surgery (Ezzatvar,2021)
Some of these complications usually depend on the type and technique of surgery you have had.
It is important to ask your doctor to explain your potential complication in advice before the procedure.
Keep in mind that these complications are relatively rare, and most people who undergo surgery do not experience them.
A total of 16 studies were included and 1157 procedures reported for percutaneous surgery of hallux valgus deformity on 1246 patients.
And here are some possible complications that were noted but these vary among the studies.
♦️18.47% of patients complained of joint stiffness.
♦️Hallux valgus recurrence in 15.2%
♦️And 15.2% of people complain of shortening of the metatarsal bone.
♦️10.1% complained of material intolerance.
♦️9.1% of operated patients complain of osteoarthritic changes.
♦️7.6% experience infection.
♦️5.4% can affect another toe causing pain.
Some people may consider undergoing surgery for independent or bilateral hallux valgus.
In the first year, pain is reduced more compared to doing nothing or wearing orthotics. However, it is unknown if the relief persists over time.
▶️Can you straighten a bunion without surgery? How to shrink bunions naturally
There are no other natural treatments that are as or more effective in treating bunion than the ones we have already discussed in this article (orthosis, shoes and exercises)
I have seen people with bunions use the following remedies for short term to help with pain relief.
♦️Essential oil
♦️Ointment
♦️Green clay
However, looking at the human body and the composition of these products, they may not effectively limit the potential worsening of the deformity of bunions.
▶️What happens if a bunion is left untreated?
If you ignore Hallux valgus yet it is giving you pain and discomfort, it will:
🟣Affect balance and gait.
🟣In the elderly, this is particularly relevant as it leads to an increased risk of falls and sustaining other fall-related injuries.
🟣You may face an increase in pain and a greater reduction in physical function, general health, social function, and mental health as severity of hallux valgus increases if overlooked.
▶️Can you play sports with bunions?
The good news is there are no contraindications, and no sport is likely to worsen the deformity.
However, you must be careful when engaging in certain sports such as:
🟣Running
🟣Soccer
🟣Hiking
These kinds of sports can increase pain and cause discomfort to your foot. Try to adjust the frequency, duration and intensity of sports sessions, gradually increasing them to find the right balance.
Conclusion: prevention and treatment of hallux valgus deformity.
I understand that you are looking for a permanent solution so that you no longer be bothered by your bunion in a lasting way.
You want to experience less pain and can do everything you want.
This article has highlighted different treatment options, based on this information it is up to you to determine if something is relevant and appropriate for your specific case.
⬛According to our current knowledge of the human body, the causes of hallux valgus is genetic so there is no miracle cure or definite treatment for this foot deformity even with surgery, recurrence is common
⬛The easiest thing to do in my opinion, is to avoid wearing shoes that can exacerbate pain and discomfort.
⬛You may consider using splints and orthosis.
It is also to keep in mind that the deformity does not necessarily worsen over time so be optimistic.
According to (Menz 2023) bunion worsened in only 1/3 of individuals around the age of 50 who were followed for 7 years
However, it is important not to expect significant results from these measures.
We have come to the end of this article. I hope I have answered some of your questions, let’s share any experience in the comments section.
Below are some of the resources I have used for further reference.wishing you a quick recovery!🙋
📚Sources:
Lewis TL, See A, Thomas M, Houchen-Wolloff L, Angadji A, McDaid C, O’Neill S, Nester C, Mangwani J; UK Hallux Valgus Think Tank collaborative; Hallux Valgus Think Tank collaborative; Abbasian A, Angadji A, Berger A, Breach J, Clayton R, Hariharan K, Hossain N, Lewis T, Mangwani J, McDaid C, Nester C, O’Neill S, Ramasamy A, Ray R, Sandford C, See A, Sott A, Thomas M, Tiruveedhula M, Withey C. The Inaugural UK National Hallux Valgus Think Tank : identification of key issues and strategies to improve clinical care for patient benefit. Bone Jt Open. 2025 Apr 14;6(4):432-439. doi: 10.1302/2633-1462.64.BJO-2024-0212.R1. PMID: 40222731; PMCID: PMC11994245.
Lisacek-Kiosoglous A, Ristanis S, Georgiou AC. The trend of hallux valgus diagnosis and treatment: NHS England, population level data (1999-2019) J Orthop Bone Res. 2021;2(1):1–14
Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg Am. 2011 Sep 7;93(17):1650-61. doi: 10.2106/JBJS.H.01630. PMID: 21915581.
Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010 Sep 27;3:21. doi: 10.1186/1757-1146-3-21. PMID: 20868524; PMCID: PMC2955707.
Menz HB, Marshall M, Thomas MJ, Rathod-Mistry T, Peat GM, Roddy E. Incidence and Progression of Hallux Valgus: A Prospective Cohort Study. Arthritis Care Res (Hoboken). 2023 Jan;75(1):166-173. doi: 10.1002/acr.24754. Epub 2022 Aug 31. PMID: 34268894.
Ying J, Xu Y, István B, Ren F. Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis. Int J Environ Res Public Health. 2021 Apr 6;18(7):3841. doi: 10.3390/ijerph18073841. PMID: 33917568; PMCID: PMC8038851.
Sherman KP, Douglas DL, Benson MK. Keller’s arthroplasty: is distraction useful? A prospective trial. J Bone Joint Surg Br. 1984 Nov;66(5):765-9. doi: 10.1302/0301-620X.66B5.6389559. PMID: 6389559.
Torkki M, Malmivaara A, Seitsalo S, Hoikka V, Laippala P, Paavolainen P. Surgery vs Orthosis vs Watchful Waiting for Hallux Valgus: A Randomized Controlled Trial. JAMA. 2001;285(19):2474–2480. doi:10.1001/jama.285.19.2474
Ezzatvar Y, López-Bueno L, Fuentes-Aparicio L, Dueñas L. Prevalence and Predisposing Factors for Recurrence after Hallux Valgus Surgery: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(24):5753. https://doi.org/10.3390/jcm10245753
Miranda MAM, Martins C, Cortegana IM, Campos G, Pérez MFM, Oliva XM. Complications on Percutaneous Hallux Valgus Surgery: A Systematic Review. J Foot Ankle Surg. 2021 May-Jun;60(3):548-554. doi: 10.1053/j.jfas.2020.06.015. Epub 2020 Dec 8. PMID: 33579548.