Managing Hallux Valgus (Bunions)

Our feet play a crucial role in our lives. Every day, they enable us to move and carry many times our body weight. This is made possible thanks to a complex interplay of muscles, bones, tendons and ligaments. A total of 26 bones, almost 30 joints and almost 60 muscles and tendons are involved. Unfortunately, because our feet withstand high stress every day, over the course of a lifetime things can go wrong. Foot problems and pain are among the most common complaints of patients throughout the world.


Bunion anatomy

Hallux valgus, or bunion, is a deviation of the big toe in the metatarsophalangeal joint towards the small toe side. Hallux valgus usually develops as a result of years of splayfoot, the most common painful deformity of the foot. This causes the 1st and 2nd metatarsal bones to spread causing incorrect stress on the foot. The cause of hallux valgus is related to weak connective tissue and obesity, and tight and raised shoes contribute to the progression.

The misalignment of the big toe often increases over time due to the changed stress caused by the splayfoot and the changed tendon pull. In severe cases, the misalignment of the big toe can also affect the adjacent foot skeleton and lead to a misalignment of the 2nd and 3rd toes.


  • Depending on how advanced and pronounced the respective clinical condition is, different therapy options come into play. In mild forms, special hallux valgus splints or insoles can be used. Otherwise, a change in footwear and targeted foot exercises can be used as a conservative therapy. Local decongestant and cooling measures often help with inflamed bursae.

  • For stronger pain and permanently occurring pain continuing during rest, surgery may sometimes be unavoidable.
  • In most cases, removing the protruding bone or the bony attachments is not sufficient. In the case of moderate and severe forms, the axis of the 1st metatarsal must often be corrected.


  • Long-soled, flat bandage shoe or forefoot relief shoe (duration: depending on the extent of the surgery)

  • Lymph drainage is possible immediately after surgery if necessary
  • Depending on the extent of the surgery and the follow-up treatment scheme, the duration of the relief of the affected foot may last from a few days to several weeks. The stress relief phase is followed by a gradual increase in stress
  • Start of mobilizing physiotherapy after the wound has healed safely (after approx. 2-3 weeks)
  • After the bone has healed and the swelling has subsided, it is possible to return to normal footwear (shoes with raised heels should be avoided)

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