Bunions around the world: Why are they so common and what can we do about them?

Introduction

Bunions (hallux valgus) are one of the most common foot conditions worldwide. In addition to pain and discomfort when walking, they impact mobility and quality of life. The good news: there are preventive and relief measures (starting with proper footwear) that can make a real difference.

What is a bunion and why does it appear?

A bunion is a bony protrusion at the base of the big toe that occurs when the toe turns inward toward the other toes, causing the joint to protrude. Factors such as heredity and foot biomechanics (flat feet, overpronation, etc.) play a role, as do narrow or high-heeled shoes, which increase pressure and promote the progression of the deformity.

How common are they globally?

A systematic review and global meta-analysis integrating 45 studies estimated a combined prevalence of 19% in the general population; the frequency increases with age and is higher in women than in men. In people over 60 years of age, the prevalence reaches ~23%; in women it is around 24% and in men it is 11%. Several studies indicate that women have more than double the risk of developing bunions, in part due to the frequent use of restrictive footwear.

The role of footwear

Epidemiological evidence shows a consistent association between wearing shoes with a narrow toe and high heels (especially during youth) and the development of hallux valgus later in life. This doesn't mean that footwear is the only cause, but it is a key modifiable factor.

What you can do today: prevention and relief (non-surgical)

Clinical guidelines and high-quality reviews recommend starting with conservative measures; in many cases, these reduce pain and can slow progression:

• Shoes with a wide toe box and low heel : reduces pressure and friction on the big toe joint.
• Insoles/orthoses and pads : These help distribute the load and relieve symptoms; in some cases, they may help slow progression.
• Night splints, exercises, and physical therapy : Evidence suggests improvements in pain and, in some studies, small reductions in bunion angle.
• Specialist consultation if there is severe pain or functional limitation : Surgery may improve pain and function in moderate to severe cases, weighing risks and benefits.

Note: Evidence regarding which conservative intervention is “best” varies across studies; however, modifying footwear and optimizing foot mechanics are first-line strategies supported by clinical guidelines.

Why choose wide-toe shoes?

Because it allows the toes to maintain their natural position, reduces high-pressure areas in the forefoot, and prevents the continuous lateral compression that promotes the progression of hallux valgus. It is a safe, accessible, and sustainable intervention for everyday use, recommended as a first step in clinical reference sources.

And where do I get this footwear?

At Luna Steps, we believe every step should feel free and natural. Our wide-toe shoes are designed to give your feet the space they need, with quality materials, adequate support, and attentive care that accompanies you throughout the process.

If you want to prevent bunions, start with the most impactful change: choose footwear that respects the natural shape of your foot.
Discover our collection and take your first step today with Luna Steps.

📚 Sources consulted

• Nix S, et al. Hallux valgus in general population: systematic review and meta-analysis. J Foot Ankle Res. 2010.
• Mayo Clinic. Bunions (Hallux Valgus) – Symptoms and Causes. 2023.
• NHS (UK). Hallux valgus management guidelines.
• Menz HB, et al. Footwear and hallux valgus in older women: Epidemiology study. 2016.
• Verywell Health, Health.com – Bunions causes, prevalence and treatments.