A ‘bunion'  (or Hallux Abducto Valgus) is an enlargement of the joint (a lump of bone) that develops overtime, at the base of the big toe.  As the bunion continues to develops it causes the big toe to deviate towards the smaller toes.


The main causes in the development of a bunion are excess pronation of the foot, combined with a short 1st metatarsal (the bone leading up to the big toe).

As the foot pronates, excessive weight is placed on big toe joint during the toe off phase of gait, which causes the big toe to deviate (towards the other toes).  As this action occurs with every step a sufferer takes, over a long period of time the joint starts to enlarge, the big toe permanently stays in a deviated position, hence the bunion becomes more visible.  Bunions can occur on 1 or both feet.

Bunions are not necessarily an entirely hereditary condition. Bunions can run in a family but it is actually the biomechanical structure (i.e. short 1st metatarsal bone, coupled with excessive pronation) that is hereditary and passed through the family - not the resultant condition itself. In some cases bunions are caused by arthritis or trauma. Fractures or breaks in the joint may lead to arthritic changes and the development of a bunion - limiting the range of motion in the joint.

Contrary to popular belief tight or ill-fitting footwear is not the primary cause of bunions. Although poor footwear in combination with causative biomechanical factors can cause bunions to develop quicker and progress further.

Bunions may be experienced in 3 stages: primary, secondary and tertiary. These stages refer to the progressive deviation of the big toe towards the smaller toes. Often, bunions in the tertiary stage cause the big toe to overlap or underlap the 2nd toe, usually limiting the patient's mobility and causing pain.

3 Stages of Bunions

     Primary                                                   Secondary                                                 Tertiary




Pain may be felt in the big toe joint, and a protruding lump is usually visible on the side of this joint, which enlarges with age. The skin and tissue around the bunion may also be swollen or inflamed, very painful or in some cases patients exhibit no pain at all.  Pain, discomfort and difficulty wearing shoes may be experienced due to the bunion deformity. Arthritis and stiffness in the joint can develop.

The lesser toes can also be affected - pressure from the big toe pushing inward toward the smaller toes can cause toe nails to begin to grow into the sides of the nail bed or the smaller toes can develop corns. A ‘hammer toe’ may also develop in the 2nd toe due the deviation of the big toe.

How Pedistep Orthotics Help

Primary and secondary stage bunions can be successfully treated with Pedistep Orthotics to realign and control the feet, preventing excessive pronation.  By controlling pronation and supporting the arch of the foot, Pedistep Orthotics re-distribute the body weight more evenly across the whole foot preventing further development of the bunion.