Massage therapy · Kitchener–WaterlooBunions

If the joint connecting your big toe to your foot is swollen, sore or has a bony bump, you might have a bunion. Bunions are common, especially as people get older: a large review found that about 23% of adults aged 18 to 65, and about 36% of people over 65, have the big-toe shape behind bunions (hallux valgus), and that it is more common in women than men (Nix, Smith and Vicenzino, 2010). Bunions are often linked to wearing shoes that are narrow and tight, especially with a pointed toe, as well as high heels. Genes also play a large part: up to 70% of people who develop bunions have a family history of them (AAOS, n.d.). Tight shoes can also cause other foot problems like calluses, corns and hammertoes.

With a bunion, the joint at the base of your big toe gets bigger and sticks out. The skin over it may become hard, swollen, tender and red. Wearing shoes can become painful because the joint flexes with every step, and the larger the bunion gets, the more it can hurt to walk. Bursitis (inflammation of the fluid-filled sac that cushions the joint) can set in and cause more pain. The big toe may angle towards the second toe or move all the way under or over it. The skin underneath the foot can become painful and thicker. Pressure from the big toe can push the second toe out of alignment. Advanced bunions change how the foot looks and can make walking difficult. Eventually, arthritis may set in and the pain can become long-lasting (AAOS, n.d.).

Bunion Anatomy

Bunions develop at the metatarsophalangeal (MTP) joint, the large joint where the first long bone of the foot meets the first bone of the big toe (AAOS, n.d.). A bunion generally starts as a small bump on the inside of the big toe joint. Over time, the bones of the joint move out of alignment, so the big toe no longer lines up with the other toes, and the joint can become stiff with limited movement (AAOS, n.d.). If the big toe gets stiff, you can lose the normal push-off from the toe when walking. A change in the way you walk may cause other problems in the lower limb and up the spine.

How to Treat Bunions

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Avoid wearing small or narrow shoes.
• Avoid heels higher than a couple of inches.
• Bunions often run in families, so if your parents had them you may be more likely to get them (AAOS, n.d.).
• Rheumatoid arthritis, and some nerve and muscle conditions, can also cause bunions (AAOS, n.d.).
• See a family doctor or nurse practitioner if the pain has not improved after a few weeks of home treatment, if it stops you doing your normal activities, if your bunions are getting worse, or if you have bunions and diabetes (NHS, 2023).
• I can give you exercises for your feet and big toe (see the My Approach tab).

A bunion is a change in the shape of the big toe joint, and hands-on work and exercise can't reverse it. What they can do is ease the pain, keep the joint moving and help your foot and leg cope better, so you stay comfortable and active.

I start by assessing how much your big toe moves, how you stand and walk, and how you push off, and I'll look at your shoes.

Easing the Pain

• Hands-on work for the muscles of the sole, calf and shin, keeping pressure off the sore bump
• Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
• Short-term taping to ease the strain on the joint, and showing you how to tape it yourself

Movement and Strength

• Gentle mobilisation of the big toe joint and the small joints of the foot, with a sustained stretch
• A home self-stretch for a stiff big toe: stand in a long stride, lift the back heel so your toes stay on the floor, and rock gently forward
• Active toe exercises, such as spreading your toes and pressing the big toe down
• Strengthening for the muscles that support your arch, building to balance and single-leg work
• Calf and ankle mobility, and work on how you walk and push off

Footwear and Supports

1. NHS (2023) Bunions. Available at: https://www.nhs.uk/conditions/bunions/ (Accessed: 7 October 2026).
2. American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Bunions. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/bunions/ (Accessed: 7 October 2026).
3. Nix, S., Smith, M. and Vicenzino, B. (2010) 'Prevalence of hallux valgus in the general population: a systematic review and meta-analysis', Journal of Foot and Ankle Research, 3, 21. doi: 10.1186/1757-1146-3-21