The medical term for a bunion is Hallux Valgus. Bunions are very common in our modern life. A bunion refers to a deformed great toe (Hallux) with lateral deviation (moving outside). The development of a bunion is caused by pressure applied to the side of the big toe, forcing it inwards towards, and sometimes under or over, the other toes.


Three Stages of Bunion Development

Primary stage

Begins with only a small protruding lump appearing on the side of the big toe. This generally occurs up to the age of 25 years old.

Secondary stage

The lump enlarges and the lateral deviation of the big toe continues. The adjacent 2nd toe may experience pressure from the big toe.

Advanced stage

If the situation is not controlled, the condition will typically worsen. Both pain and swelling will appear and worsen, the big toe will overlap the adjacent 2nd toe, and normal shoes will no longer suit or fit.


  • Underlying faulty foot biomechanics. Excessive pronation causes additional forces in the forefoot (with the 1st metatarsal being the most vulnerable). The ground reaction force, in turn, forces the big toe (hallux) to compensate by deviating away from the parallel median axis of the body (i.e. ‘abducting’). Over time, this deviation will manifest on the outer edge of the foot, forming bunions.
  • Tight fitting or high heeled shoes
  • Flat feet
  • Excessive flexibility of ligaments
  • Abnormal bone structure
  • Certain neurological conditions


  • Orthotic footwear (orthoses), especially quality made over-the-counter orthotic shoes/sandals/thongs, often help prevent bunions from developing to the advanced stage. Orthoses can help realign the foot by supporting & controlling the heel bone from deviating outwards, thereby correcting over pronation by taking excess pressure off especially the 1st metatarsophalangeal joint. Preventative measures are generally considered especially important in the treatment of bunions.
  • Surgery for advanced stage bunions.