Bunions and big toe joint pain (hallux rigidus)
What bunions and a stiff, arthritic big toe joint are, what helps with footwear and pain, and when treatment or referral is considered.
Two different problems often get mixed up at the base of the big toe. A bunion is a bony lump on the side of the foot at the base of the big toe, which may lean toward the other toes. Hallux rigidus is arthritis of the big toe joint, which causes pain and stiffness, particularly when the toe has to bend as you push off.
When to get urgent help
Go to A&E or call 999 if you have any of these. They can be signs of a fracture, infection, blood clot or other emergency.
- A limb that looks deformed, or a joint that you cannot move or put weight on after an injury
- A cold, pale or numb foot or hand after injury
- A hot, red, swollen joint with a high temperature
- A painful, swollen, warm calf, with or without breathlessness or chest pain
What it can feel like
- A hard lump on the side of the foot at the base of the big toe, sometimes red, swollen or tender
- Pain along the side or sole of the foot, worse in shoes and when walking
- A big toe joint that is stiff, painful or hard to bend, with pain from shoe pressure on the joint
- Calluses or sore spots under or between the toes
Common contributors
- Bunions tend to run in families, and are made more uncomfortable by tight, narrow or high-heeled shoes
- Hallux rigidus is arthritis of the joint, where the cartilage wears away and bone spurs may form
- An old injury to the toe joint can contribute
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- The NHS advises wearing roomy shoes with a low heel and a cushioned sole, and avoiding high heels and tight, pointed shoes
- Bunion pads from a pharmacy can cushion the area, and an ice pack wrapped in cloth may ease soreness for short periods
- A hospital foot-and-ankle leaflet suggests a shoe with a stiffer sole or a rocker sole for a painful arthritic big toe joint
- Trimming calluses and using soft pads can help with pressure pain elsewhere on the foot
- If you use paracetamol or ibuprofen, follow the packet instructions or ask a pharmacist
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Pain after a significant injury, fall or twist
- Pain that is constant, severe or getting worse, or wakes you at night
- Unexplained weight loss, fever or feeling generally unwell with limb pain
Consider seeing your GP if:
- Pain not improved after a few weeks of home treatment, or pain that is limiting your daily activities
- A bunion that is getting worse
- You have diabetes. Foot problems can be more serious, so ask for a foot check
- A hot, red, swollen toe joint with fever, or a sore that is not healing
Where an osteopath fits in
There is limited good-quality research showing that hands-on treatment changes the course of bunions and big toe arthritis, so I do not claim that osteopathy treats it.
What an osteopath can usefully do is assess your foot, ankle and the way you walk, advise on footwear and activity, and suggest seeing a podiatrist or your GP if insoles, toe devices or a surgical opinion could help. The NHS says surgery is the only way to remove a bunion, but other steps can ease the pain, and surgery is considered when pain is severe or greatly affects daily life. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
Can bunions be treated without surgery?
The NHS says surgery is the only way to remove a bunion, but wider shoes, pads, painkillers, and sometimes insoles, toe spacers or splints suggested by a GP or podiatrist can ease the pain. Surgery is usually considered only when pain is severe or greatly affects daily life.
What is the difference between a bunion and a stiff big toe?
A bunion is a bony lump on the side of the big toe joint. A stiff, painful big toe joint with limited bending is more typical of hallux rigidus, which is arthritis of the joint. The two can occur together, and a foot specialist can tell them apart.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
- NHS: Bunions
- Norfolk and Norwich University Hospitals: Arthritis of the big toe joint (hallux rigidus)
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.