Bunions develop from a combination of inherited foot shape and how the foot loads when you walk. Genetics is the biggest factor (if your mum or gran had them you're more likely to). Other contributors include flat feet, very flexible joints, decades of tight or high-heeled shoes and conditions like rheumatoid arthritis. Bunions are not caused by tight shoes alone but tight shoes worsen them once they've started.

The first sign is usually a small bump at the base of the big toe and shoes that feel tight on that side. Over time you'll notice pain in the joint (especially in shoes or after activity), redness or swelling around the bump, the big toe drifting towards the second toe and sometimes pain across the ball of the foot as weight distribution changes. Some people develop a smaller bump on the outside of the foot at the base of the little toe, known as a bunionette.

A clinical examination is usually sufficient. The podiatrist looks at the position of the big toe joint, range of motion, any tenderness, how the foot loads when you stand and walk and any related changes in the rest of the foot. For severe or surgical-stage bunions, X-rays are useful to see the precise angle of the bones.

We tailor the programme to the stage:

• Footwear assessment and recommendations
• Custom orthotics to offload the painful area and correct biomechanics
• Padding and toe spacers for symptom relief
• Targeted exercises and stretching to maintain joint mobility
• Pain management strategies for flare-ups
• Surgical referral and post-op support when conservative care isn't enough

No, conservative treatment can't reverse a bunion or change the underlying bone position. What it can do, very effectively, is reduce the day-to-day pain, slow further progression and keep you active and in normal shoes for longer. Many people with bunions live with them perfectly comfortably for decades with the right management. Only persistent severe pain or significant deformity typically warrants surgery.

Bunion surgery is usually considered when: pain is severe and affecting daily activities, you've exhausted conservative options without enough improvement, the deformity is severe or rapidly progressing, the second toe is being pushed out of alignment, or you can no longer find any comfortable footwear. Surgery is not done for cosmetic reasons or for mild bunions. We'll discuss timing and refer you to an orthopaedic foot surgeon when it's the right move.

Bunion correctors and splints don't reverse the bony deformity but they can help with comfort. Night splints can help maintain flexibility and reduce stiffness in the morning. Toe spacers ease pressure between the big toe and second toe. They're useful additions but they won't replace proper biomechanical assessment and custom orthotics for the underlying cause.

If bunions run in your family there's a higher chance. The good news is that catching early signs and using appropriate footwear, orthotics if needed and good foot hygiene from a young age can significantly slow progression. If you're worried about a child's foot development we're happy to do a biomechanical assessment to spot early signs.

For your first appointment, allow up to 60 minutes. This gives us enough time for a thorough history, examination and treatment in the same visit. Follow-up treatments are typically up to 30 minutes for the vast majority of cases. We'll confirm the exact length when you book.

No. You can book a podiatry appointment directly with us with no GP referral needed. We can write to your GP after your appointment if there's anything they should know.

Wear something comfortable that's easy to roll up to the knee. Bring the shoes you wear most often (we'll often look at how they're wearing for biomechanical clues). If you've had any imaging or test results related to your feet, bring those too. Otherwise just bring yourself.

Podiatry & chiropody is available at our Great Dunmow clinic at 12 Stortford Road, CM6 1DA. The clinic has on-site disabled parking available on request. Just give us a call ahead of your appointment.