Bunions

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Painful bunion or big-toe bump? Get evaluation, conservative care, and minimally invasive bunion surgery when needed. Same-week care in San Mateo.

A bunion (hallux valgus) is a bony prominence at the base of the big toe where the first metatarsal and toe meet. Over time, the big toe drifts toward the second toe, creating a visible bump, shoe pressure, and pain.

Common symptoms

• Soreness, burning, or aching at the big-toe joint
• Redness or callus from shoe rubbing
• Stiffness or difficulty fitting shoes
• Overlapping or crowding of the smaller toes

Why it happens (risk factors)

• Family history and foot shape (flatfoot, hypermobility)
• Tight or narrow footwear over many years
• Ligament laxity, calf tightness, or prior injuries
• Inflammatory conditions (e.g., arthritis)

We start with a focused history and exam, shoe review, and gait assessment. Weight-bearing X-rays (standing) help measure angles, assess joint quality, and guide treatment—from conservative options to the right surgical approach if needed.

Many people find relief without surgery, especially early on.

Footwear & supports

• Wider, deeper toe boxes; soft uppers that don’t rub the bump
• Custom orthotics to improve alignment and reduce pressure (especially helpful with flatfoot or hypermobility)
• Gel spacers or pads to decrease friction

Symptom relief

• Activity and training modifications during flares
• Ice and short courses of anti-inflammatory measures (as appropriate)
• Calf and foot mobility work; targeted strengthening for stability

We’ll tailor your plan to your symptoms, shoe needs, and activity goals.

Surgery is an option when pain limits daily life despite appropriate conservative care, or when deformity progresses (overlapping toes, recurrent corns, shoe intolerance).

Procedures we consider (selected to match your anatomy and goals):

• Minimally invasive bunion surgery (MIBS): Small incisions with specialized instruments to realign the bone and soften tissues, often with less soft-tissue disruption and faster shoe comfort.
• Distal metatarsal osteotomy (e.g., chevron/scarf) with fixation to realign the first metatarsal.
• Akin osteotomy to fine-tune big-toe alignment.
• Lapidus procedure (first tarsometatarsal fusion) for larger or unstable deformities, particularly with hypermobility or recurring bunions.
• Arthritic joint options when cartilage is severely worn.

We’ll discuss benefits, risks, recovery timelines, and shoe/sport expectations so you can make an informed decision.

1. Evaluation: Exam, weight-bearing X-rays as needed, review of shoes and activities.
2. Plan: Clear conservative plan (shoes, orthotics, pads, exercises). If surgery is appropriate, we’ll outline the approach and recovery steps.
3. Follow-up: Progress check to ensure pain relief and fit improvements; surgical patients receive a detailed rehab timeline.

• Sudden severe pain or inability to bear weight after an injury
• Signs of infection (spreading redness, fever, drainage) around an irritated bunion or skin breakdown
• Numbness, tingling, or rapidly worsening swelling

• Board-certified care led by Hannah Lee, DPM
• Emphasis on conservative treatment first, with shoe and orthotic guidance
• Minimally invasive and reconstructive surgical options tailored to your foot type
• Clear recovery plans to help you return to work, walking, and sport comfortably

Will shoes alone fix a bunion?
They don’t reverse the deformity but can greatly reduce pain and rubbing. Supportive shoes + orthotics often keep symptoms controlled.

Do orthotics correct the bunion?
Orthotics don’t “shrink” the bump but can slow progression and reduce pain by improving mechanics and offloading pressure.

What’s recovery like after surgery?
Depends on the procedure. Many patients weight-bear in a boot right away for minimally invasive procedures; others need a brief non-weight-bearing period. We’ll outline return-to-work and shoe timelines for your case.

Will it come back?
Recurrence risk is lower when the right procedure is chosen for your foot structure and when shoe/orthotic guidance is followed post-op.

Let’s create a plan that fits your lifestyle—starting conservatively and advancing only if needed.