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Bunion/Hallux Valgus Treatment Sydney

Bunions are a common foot problem that we treat at our North Sydney Podiatry clinic using non-surgical treatment options. A bunion, clinically referred to as hallux valgus, is a bony prominence near the base of the big toe joint (also known as the metatarsophalangeal (MTP) joint) or on the 5th toe joint (little toe).

It is a foot deformity that affects the normal position of the toe and can get worse over time due to the increased pressure on the joint from daily activities like walking and standing. As a result, the big toe may slowly move towards the second toe, narrowing the gap and, in very advanced cases, even overlapping or underlapping the second toe.

For many, this joint deformity can be uncomfortable and painful, and for others, the issue can be simply aesthetic. Severe bunions can be extremely debilitating, making walking and other daily activities difficult and/or very painful.

As the bunion increases the width of the foot, the large bony lump can limit footwear options as it is difficult to find shoes wide enough to accommodate the extra width of the foot. This can make wearing shoes uncomfortable as the bunion rubs against the side of the shoe, causing inflammation and pain.


There are multiple causes of bunions, and sometimes it can be a combination of factors.

Biomechanical Abnormalities

A very common cause of bunions is incorrect foot mechanics. Abnormal foot mechanics result in an imbalance of forces on the

joints and tendons, which can put increased pressure on the MTP joint causing a bunion to form over time. Some examples of abnormal foot biomechanics include:

  • Flat feet or low arch causing the foot to overpronate (ankles roll inwards)

  • Very flexible feet with loose ligaments

  • Feet that excessively abduct or are out-toed.

  • Feet with a short first metatarsal

Genetic predisposition

Some people are predisposed because they've inherited a foot type, such as flat feet. This results in poor foot mechanics, which may increase the chances of a bunion developing.

If you have a family history of bunions, it's not always a guarantee that you will develop them.

Medical Conditions

Diseases such as arthritis, specifically rheumatoid arthritis can cause joint damage. This damage can result in their formation. Other medical conditions that can cause bunions include neuromuscular disease and gout.


Weakness in the leg and foot muscles as a result of past injuries may increase the chance of developing bunions.

Symptoms of Bunions

They are quite easy to recognise, but some people may not notice them until they feel bunion pain. It may start as a small boney lump that increases in size over time either on the base of the big toe or on the little toe. Other symptoms beyond the physical lump include:

  • Discomfort & pain

  • Redness around the joint

  • Burning sensation

  • Numbness of the toe

  • Inflammation of the joint

  • Restricted movement of the affected toe

  • Increased skin thickness or hardening of the skin around the base of the affected toe

  • Corns & calluses as a result of the overlapping of the toes

How Can A Podiatrist Help?

A common misconception is that a surgical approach is the only option to treat bunions, but there are many conservative treatments that can relieve pressure and pain and slow down the joint deformity. These methods will not fully reverse the deformity itself, but can greatly reduce the symptoms. An orthopaedic surgeon may even recommend conservative treatments first before going down the path of bunion surgery as there is minimal risk compared to surgery.

To properly diagnose a bunion deformity, a Podiatrist will carry out a biomechanical assessment and review your medical history. A biomechanical assessment, also known as a gait assessment, involves assessing your foot & body’s biomechanics. This involves analysing how different parts of your body move and if they are functioning and moving together correctly.

The results of these assessments will help a Podiatrist properly diagnose your issue and determine the best treatment.

Custom Orthotics

A common conservative bunion treatment option is custom orthotics. An orthotic device can help treat bunions as it is tailored to a person's unique bone structure and foot issues. They will help improve foot function and gait alignment, which can slow down bunion progression or even prevent them if prescribed early enough. After official treatment concludes, they can continue to be used to reduce joint malalignment.

Other Treatments:
  • Footwear changes

  • Sports strapping

  • Foot padding

  • Stretches

  • Modifying daily activity that causes bunion pain

  • Joint mobilisation

  • Exercises

For a more severe bunion, if conservative bunion treatment methods have failed to relieve symptoms, surgical options may be the next step and we work very closely with some surgeons who specialise in bunions. However, bunion surgeries may have poor surgical outcomes, with many bunions reforming over time or transferring deformities e.g. retracted second toe. This is because most surgical interventions do not address the root cause of why the bunion is occurring in the first place.

What to Bring to My Appointment

Please bring the following information to your appointment:

  • Current footwear including sports shoes & everyday shoes

  • Shorts/tights so you can comfortably do the assessments

Don’t Ignore Your Bunions

A bunion will not go away on its own and will probably get worse over time if left untreated. Early intervention may be the best way to avoid bunion surgery in the future.

At North Sydney Podiatry, we believe early diagnosis and treatment are key to relieving pain and slowing the progression of a bunion.

We have many years experience treating feet with issues such as bunions. If you want to get to the root of whatever’s causing yours, contact our team today for an assessment by calling (02) 9954 3445 or filling out our booking form.

Frequently Asked Questions

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