: Everything You Need to Know About Causes, Treatment & Prevention

Creator: Central Florida Foot & Ankle Institute
Published: 2025-01-27

Key Takeaways:

are progressive—they don't go away on their own and typically worsen over time
Not all require surgery; many respond well to conservative treatment
Heredity plays a bigger role than footwear, though shoes can accelerate progression
Early intervention offers more treatment options and better outcomes

What Exactly Is a ?

A —medically known as hallux valgus—is more than just a bump on your foot. It's a complex structural deformity that develops when the bones in the front part of your foot shift out of alignment.

Here's what happens: The big toe gradually angles toward the second toe, causing the joint at the base of the big toe to jut outward. That bony protrusion you see? That's actually the head of your first metatarsal bone becoming increasingly prominent as the alignment worsens.

At Central Florida Foot & Ankle Institute, are one of the most common conditions we treat. They affect an estimated 23% of adults, with women experiencing them far more frequently than men.

The Progression: How Develop

don't appear overnight. They develop gradually over years, often decades, which means many people ignore early warning signs until the condition significantly impacts their daily life.

Stages of Development

Stage 1 - Mild: The big toe begins to lean slightly toward the second toe. A small bump may be visible, but pain is minimal or absent. Stage 2 - Moderate: The angle increases noticeably. Pain becomes more frequent, especially during activity or in certain shoes. The bump is clearly visible. Stage 3 - Severe: The big toe may overlap or underlap the second toe. Pain is consistent, and finding comfortable footwear becomes increasingly difficult. Secondary problems like may develop. Stage 4 - Very Severe: Significant joint damage and arthritis. Daily activities are substantially impacted. Surgical correction becomes more complex.

What Causes ?

The short answer: genetics loads the gun, lifestyle pulls the trigger.

The Hereditary Factor

If your mother or grandmother had , you're significantly more likely to develop them. What you inherit isn't the itself, but the foot structure that makes you susceptible—factors like:

or low arches
Loents and joints
Abnormal bone structure
Certain neuromuscular conditions

Contributing Factors

Footwear Choices: While shoes don't cause , they can accelerate their progression. Narrow, pointed shoes crowd the toes, increasing pressure on the big toe joint. High heels shift body weight forward, compounding the problem. Foot Injuries: Trauma to the foot can alter mechanics and contribute to formation. Inflammatory Conditions: Rheumatoid arthritis and other inflammatory diseases increase risk. Occupation: Jobs requiring tight dress shoes or extended standing may worsen existing tendencies.

Symptoms Beyond the Bump

While the visible bump is the most obvious sign, cause a range of symptoms that affect daily life:

Common Symptoms

Visible bump at the base of the big toe
Pain and tenderness around the joint, often worsened by shoes
Redness and swelling over the
Restricted movement of the big toe
or corns where thub together
Difficulty finding shoes that fit comfortably
Pain when walking or standing for extended periods

Secondary Problems

Left untreated, often lead to additional foot problems:

in the smaller toes
Bursitis (inflammation of fluid-filled pads)
Metatarsalgia (pain in the ball of the foot)
Arthritis in the big toe joint

Treatment Options: From Conservative to Surgical

At CFFAI, we always explore conservative treatments first. Surgery is reserved for cases where non-surgical options haven't provided adequate relief.

Conservative Treatments

Proper Footwear: This is foundational. Shoes with a wide toe box, good arch support, and low heels reduce pressure on the and slow progression. Custom Orthotics: Medical-grade shoe inserts correct abnormal foot mechanics, redistribute pressure, and can significantly reduce pain. We custom-mold these to your foot's exact specifications. Padding and Taping: pads cushion the bump against shoe irritation. Taping can help maintain proper toe alignment. Medications: Over-the-counter anti-inflammatories help manage pain and swelling during flare-ups. Ice Therapy: Apply ice for 15-20 minutes to reduce inflammation after prolonged standing or activity. Injection Therapy: Corticosteroid injections can provide relief for inflamed joints. Physical Therapy: Exercises to maintain joint mobility and strengthen supporting muscles.

When Is Surgery Necessary?

We recommend considering surgery when:

Pain interferes with daily activities despite conservative treatment
Chronic inflammation doesn't respond to rest or medication
The toe has drifted so far it crowds or crosses over other toes
Stiffness prevents normal bending and straightening
Pain isn't relieved by switching to larger or more comfortable shoes

Modern surgery has advanced significantly. Minimally invasive techniques often allow faster recovery and less post-operative pain than traditional methods.

Prevention and Slowing Progression

While you can't change your genetics, you can take steps to slow progression and reduce discomfort:

Daily Prevention Strategies

Choose shoes wisely: Wide toe boxes, low heels (under 2 inches), and good arch support
Avoid pointed shoes: These crowd toes and accelerate formation
Go barefoot when appropriate: On soft surfaces at home, this allows toes to spread naturally
Stretch regularly: Toe stretches and exercises help maintain flexibility
Monitor changes: Early intervention offers more treatment options
Use orthotics: If you have a family history, custom orthotics can help prevent progression
Maintain healthy weight: Reduces stress on foot joints

Exercises for Relief

Toe spreads: Spread your toes wide, hold for 10 seconds, repeat
Toe circles: Rotate your big toe in both directions
Towel scrunches: Use your toes to scrunch a towel toward you
Marble pickups: Pick up marbles with your toes

When to See a Podiatrist

Don't wait until your is severe. Schedule an evaluation if you notice:

A visible bump forming at the base of your big toe
Persistent pain in the big toe joint
Decreased movement in your big toe
Difficulty finding comfortable shoes
The bump appears to be growing or the toe angle worsening

Early assessment allows us to create a prevention plan that may delay or eliminate the need for surgery.

If you're concerned about , schedule an appointment with our experienced podiatrists today.

About Central Florida Foot & Ankle Institute

At CFFAI, Dr. Carli Hoover and Dr. Sean Griffin provide expert podiatric care across Central Florida. With locations in Orlando, Kissimmee, Lake Mary, and Oviedo, world-class foot and ankle care is always close to home.

Take the first step toward relief. Book your appointment today →

Key Takeaways