This page describes the condition of Bunions and the approach to this condition adopted by Mr Bowyer. Other surgeons may use variations on the techniques, for instance with regard to post-operative management. It is important that you understand what your own surgeon intends to do, and how you will be treated after the procedure.


Gavin BowyerA bunion is a bony lump at the base of the big (first) toe, caused by angulation of the big toe as it drifts sideways. The big toe then points toward the smaller toes, this is called Hallux Valgus. Pain is often due to footwear rubbing, crowding of the smaller toes, and sometimes from the joint itself.

Common Signs and Symptoms

  • An outward – turned big toe that may overlap the second toe or cause the 2nd toe to claw
  • Thickened skin over the bony protrusion at the base of the big toe (callus)
  • Occasionally, fluid accumulation under the thickened skin (called bursitis); skin may become red, tender, and swollen with constant irritation or pressure
  • Foot pain and stiffness


  • Genetics (you are born with or predisposed to it, with others in your family having it)
  • Bunions are associated with wearing shoes with a narrow toe box (pointy shoes), but certainly not in all cases – your family genetics are more likely to be to blame than your mother’s choice of shoe when you were a child

Preventive/Non-operative Measures

  • Wear wide-toed shoes that fit well. Avoid shoes with high heels
  • Wear a small pad between the big toe and second toe
  • Wear a bunion pad (like a large felt polo mint) over the bony prominence at the base of the first toe
  • Shoes may be made or adapted to accommodate the bunion
  • Some bunions are caused by “flat feet” and can therefore be helped by specially made insoles / arch supports
  • Once the big toe is pushing on the second toe, or the big toe starts to twist around, then non-operative measures are not likely to bring about a lasting improvement in the condition. Surgery should only be undertaken if you have significant symptoms, and appropriate non-operative management has been considered

Surgery can be considered if there are significant symptoms or any restrictions of activity. There are several surgical options which will need to be discussed and considered.

For surgery details, click here. 

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