Bunion (Hallux Valgus)

A bunion can be described as a bony bump which develops at the base of the big toe. It is created when the big toe pushes against the toe adjacent to it and forces the big toe joint to become larger, sticking out. The skin which is directly over the bunion can become sore and red in colour.

Smaller bunions, known as bunionettes, can form on the little toe joint.


The exact cause of bunions is not yet fully understood. However, there are a few known contributing factors, such as foot injuries, deformities from birth, and inherited foot type. There is still a debate on whether shoes which are too tight or narrow can cause bunions, or if footwear can speed up the development of bunions. Some types of inflammatory arthritis, including rheumatoid arthritis, can be associated with bunions.

Individuals who wear ill-fitting shoes or high heels, have rheumatoid arthritis, or have inherited a foot defect, are understood to be at a higher risk of developing a bunion.


The predominant symptom of a bunion is a bulging bump which is situated at the base of the big toe. It is also typical to experience soreness around the big toe joint, as well as redness and swelling. Pain - ranging from persistent to on-off - can be experienced, and it is also common for calluses and corns to develop at the point where the first and second toes overlap. In cases where arthritis affects the big toe, bunions can also cause inhibited movement of the joint.

Among the symptoms which require you to seek medical help from a doctor, orthopaedic foot specialist or podiatrist are a visible bump on the big toe joint; persistent pain in the big toe or foot; significantly decreased movement of the foot and big toe, and difficulty fitting into shoes due to a bunion.


The treatment path which is chosen for a bunion will depend on the level of pain and severity. Among the non-surgical treatments which can be effective are changing to more comfortable and spacious shoes; medications such as ibuprofen, acetaminophen and naproxen sodium; non-medicated bunion pads; taping, which can align the foot in a normal position; shoe inserts, which can help to distribute pressure more evenly when walking; arch supports bought over the counter; and the application of ice.

In cases where the treatments above have not offered adequate relief, surgery can be opted for. This is typically only in cases where a bunion is causing you to experience regular pain and disrupting your daily life.

Minimally invasive surgery is the standard technique used by Mr Ajis but patients have to be suitable for it.
The bunion correction is performed through 3 or 4 very small incisions, only 3-4 millimetres long. This is in contrast to traditional surgery performed through large cuts on the foot.

Surgical procedures can include the removal of part of the bone in order to straighten the big toe; the removal of swollen tissue; permanently joining the bones of the affected joint; the realignment of the bone between the big toe and the back part of the foot; and fusing the bones in the big toe joint together permanently.

Full recovery following surgery can vary from weeks to several months. You should be able to walk on the foot soon after the procedure.

As with all foot surgery it is normal for swelling to persist for some months after surgery and is completely normal. This swelling will eventually completely subside with time and can take up to 12 months but often goes well before this.

Ankle pain can be distressing, especially if you're not sure what options are open to you. If you're wondering if surgery could help you, book an appointment.

* Routine private appointments either face to face or remotely are available

Call the urgent appointments hotline 0333 050 8662


Hear what our patients have to say

Patient stories

Mr Ajis is a great surgeon, he listens to any concern you may have and explains what is going to happen also gives great care... He suggested a fairly new procedure that wasn't available on the NHS but he pushed me through and he and his team have worked wonders, I am now healing very well and pain-free in my ankle after 6 years!

Written by a patient at BMI Goring Hall Hospital

Mr Ajis was very informative and reassuring about my surgery. He was professional at all times and allowed time for me to have all my questions answered without feeling rushed.

Written by a patient at BMI Goring Hall Hospital

I saw Mr Ajis after sustaining a fracture of my 5th metatarsal which had not healed after a year. The pain was unbearable. He saw me promptly and took the time to explain my condition with the help of x-ray images with assurances that he could fix the problem. I was advised by other clinicians to be patient and wait for the fracture to heal on its own. Mr Ajis said that healing would be highly unlikely without intervention. After numerous emails and 'phone calls to him he constantly...

...spent the time reassuring me and patiently going over the intended procedure. To date after seeking advice and guidance from Mr Ajis, his secretary and the Physio Team and the insertion of a plate my fracture has united I walk well, without pain and I have joined a walking group. In summary, he is the best foot consultant the South of England can provide. In fact, I travelled from both the IoM and the IW to West Sussex to see him.