Bunions – Hallux Abducto Valgus or HAV

Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.

A bunion (also referred to as hallux abducto valgus) is often described as a bump on the side of the big toe. But it is more than that. The visible bump actually reflects changes in the bony framework of the forefoot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.


Bunions are most often caused by an inherited faulty mechanical structure of the foot.


Symptoms, which occur at the site of the bunion, may include:

  • Pain or soreness
  • Inflammation and redness
  • Burning sensation
  • Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions even when you are not wearing tight shoes.
Because bunions are progressive, they don’t go away, and will usually get worse over time. Not all cases are alike – some bunions progress more rapidly than others. Once your podiatrist has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Non-Surgical Treatment

Most bunions that we see are biomechanical in origin and in 80% of cases, we can get rid of the pain and stop the progression with custom made orthotics.


If non-surgical treatments fail to relieve the pain and/or if it starts causing changes to the 2nd and/or 3rd toe, it’s time to discuss surgical options with your surgeon podiatrist.
The goal of surgery is the reduction of pain and the realignment of joint. The aim is to correct what was the cause of the bunion and prevent it from reoccuring.  The recovery period will vary, depending on the procedure or procedures performed as well as the overall medical history of the patient.  There are risks associated with any surgery and these should be discussed with the surgeon. Less than 10 percent of patients experience complications from bunion surgery. These can include infection, a recurrence of the bunion, damage to the nerves, and continued long term pain. Most of these are treatable.