Bunion (Hallux Valgus) Treatment
In Singapore

Living with a bunion can affect more than appearance alone. Persistent aching, difficulty finding comfortable shoes, and discomfort during everyday activities such as walking or standing may gradually affect daily function and quality of life. Many people delay seeking assessment because they are unsure whether treatment is appropriate or what the available options involve.

At ACME Orthopaedics, our orthopaedic surgeon assesses bunions based on your individual foot structure, symptoms, activity level, and lifestyle needs. Whether your bunion is mild and recently noticed, or longstanding and increasingly troublesome, a thorough consultation helps determine the most appropriate management approach.This page explains what bunions are, how they develop and progress, and the treatment options available in Singapore — from conservative management through to minimally invasive surgical correction.

Dr Zackary Chua

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (Aus)MMed (SG)MRCS (Glasgow)FRCSEd (Orth)

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Types Causes & Risks Symptoms Diagnosis Treatment Recovery Complications Prevention Adolescent Bunion FAQ

What Is a Bunion (Hallux Valgus)?

A bunion, known clinically as hallux valgus, is a bony prominence that forms at the base of the big toe where it meets the foot. It develops when the metatarsophalangeal (MTP) joint — the joint connecting the big toe to the first metatarsal bone — gradually shifts out of alignment. As the big toe angles towards the second toe, the joint protrudes outward, creating the visible bump commonly associated with a bunion. The bump itself is the repositioned joint rather than a new growth of tissue. Over time, the skin over the bump may thicken and become sore, bursitis (inflammation of the fluid sac over the joint) may develop, and, in some cases, arthritis can occur. Without appropriate management, bunions often progress gradually, although the rate of progression varies between individuals.

Types of Bunions

Primary Bunions

These are the most common type and usually develop gradually due to a combination of inherited foot structure and biomechanical factors affecting walking and weight-bearing.

Secondary Bunions

These arise as a result of underlying conditions such as rheumatoid arthritis, gout, or certain neuromuscular disorders that alter the forces acting across the foot joints.

Juvenile and Adolescent Bunions

These develop during childhood or adolescence, often in individuals with a strong family history. They may progress during growth spurts and can require a different management approach from adult bunions.

What causes a bunion to develop?

Bunions usually develop due to a combination of factors rather than a single cause. The following may contribute to the gradual development of hallux valgus:

Inherited foot structure — flat feet, a long first metatarsal, or ligamentous laxity (loose joints) may predispose the MTP joint to gradual misalignment
Joint hypermobility — excessive movement at the first tarsometatarsal (TMT) joint can allow the first metatarsal to drift inward over time
Biomechanical imbalances — irregular gait patterns may place uneven pressure across the forefoot
Inflammatory joint conditions — conditions such as rheumatoid arthritis and gout can damage joint integrity and contribute to deformity progression.

Who is at higher risk?

Bunions are more commonly seen in:

Women
People with a family history of bunions or a flexible, hypermobile foot structure
Those who regularly wear narrow, pointed, or high-heeled footwear (heels above approximately 5 cm)
Individuals whose occupations involve prolonged standing or walking on hard surfaces
Older adults, as joint structures may become less resilient with age
People with a history of foot or ankle injuries that have altered load distribution

Signs and Symptoms of a Bunion

Bunion symptoms often develop gradually and may worsen over time. Symptoms vary depending on the severity of the deformity.

Mild Bunion

A visible bony bump at the base of the big toe with little or no pain at rest
Discomfort after prolonged standing or walking
Mild redness or skin thickening over the bump
Difficulty finding comfortable shoes, particularly those with a narrow toe box

Moderate Bunion

Persistent aching, including discomfort during rest
Swelling and tenderness around the MTP joint
Reduced range of movement in the big toe
Corns or calluses where toes rub against each other

Severe Symptoms

Constant or near-constant pain that limits daily activities and affects sleep
The big toe overlapping or crossing under the second toe
Difficulty wearing standard-width footwear
Arthritis or bursitis affecting the MTP joint

When should you see a specialist?

Consider consulting our orthopaedic specialist if bunion pain affects your daily activities, limits your footwear choices, or the deformity is worsening. Early assessment helps determine the most appropriate treatment options.

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How Is a Bunion Diagnosed?

how the bunion affects your daily activities. This is followed by a physical examination and, where appropriate, imaging studies.

Clinical assessment

Physical examination to assess joint alignment, mobility, range of motion, and areas of tenderness
Gait assessment to identify biomechanical factors contributing to the deformity
Review of footwear habits, occupation, and activity level

Imaging

Weight-bearing X-rays — the primary diagnostic tool, used to measure the hallux valgus angle (HVA) and intermetatarsal angle (IMA), and assess for arthritis
MRI or ultrasound — may be recommended if soft tissue injury, bursitis, or nerve involvement is suspected
Gait analysis — occasionally used to guide orthotic prescription or surgical planning

Treatment Options for Bunions in Singapore

Treatment depends on the severity of the deformity, your symptoms, activity level, and personal goals. Not every bunion requires surgery. Many bunions can be managed without surgery, while others may benefit from surgical correction when symptoms persist despite conservative treatment.

Non-surgical treatment options

Non-surgical treatment aims to relieve pain, reduce inflammation, and improve foot function. While these measures do not correct the underlying bony deformity, they can help manage symptoms and improve daily comfort.

Footwear modification

Choosing shoes with a wide toe box, soft uppers, and heels below 5 cm can help reduce pressure on the bunion. Our specialist can recommend footwear suited to your foot shape and lifestyle.
Custom orthotics

Custom-made insoles help redistribute pressure across the foot and improve support during walking. They may be particularly beneficial if flat feet or other biomechanical factors contribute to your symptoms.
Physiotherapy and exercises

Targeted exercises can help maintain joint mobility, strengthen the muscles supporting the big toe, and improve flexibility. Examples include towel scrunches, toe stretches, and resistance band exercises.
Padding and toe spacers

Protective padding helps reduce friction between the bunion and footwear. Silicone toe spacers may provide temporary symptom relief and improve toe positioning while in use but do not permanently correct the deformity.
Injection therapy

Corticosteroid injections may be considered to reduce inflammation associated with bursitis or painful flare-ups. They provide temporary symptom relief but do not treat the underlying bunion deformity.

Surgical Treatment Options

Surgery is considered when non-surgical measures have not provided adequate relief or when the deformity is significantly affecting daily life. The goal of surgery is to realign the joint, remove the bony prominence, and improve function. Technique selection is based on deformity severity, joint condition, and individual patient factors assessed during consultation.

Minimally invasive bunion correction (MIS) with SPEAR plate

Best suited for: Mild to moderate deformity; patients seeking a minimally invasive approach.

ACME Orthopaedics performs minimally invasive bunion correction using the SPEAR plate system. This technique uses small keyhole (percutaneous) incisions — each less than 1 cm — to access and reposition the first metatarsal bone under fluoroscopic (X-ray) guidance. The repositioned bone is secured with an internal plate and screws. Because soft-tissue disruption is reduced compared with traditional open surgery, postoperative swelling may be lower, and recovery may be quicker for suitable patients.

Incisions: 2 to 3 percutaneous portals, each under 1 cm
Fixation: SPEAR plate with cortical screws for stable internal fixation
Anaesthesia: general or regional (spinal or ankle block)
Typical duration: approximately 45 to 75 minutes

Scarf osteotomy

Best suited for: Moderate deformity; allows precise multiplanar correction.

A Z-shaped cut is made along the length of the first metatarsal, allowing the bone to be shifted laterally into correct alignment. The repositioned bone is secured with two cortical screws. The Scarf osteotomy is a well-established technique that allows correction across a broad range of bunion deformities.

Incision: single medial incision along the first metatarsal
Fixation: two cortical screws
Correction capability: mild to moderate hallux valgus angle

Chevron osteotomy

Best suited for: Mild to moderate deformity; one of the most widely performed bunion techniques worldwide.

A V-shaped cut is made at the head of the first metatarsal to shift the bone and correct the angular deformity. The repositioned segment is secured with a screw or wire. This technique is well established and commonly used for appropriately selected patients with mild to moderate bunions.

Incision: single medial incision at the metatarsal head
Fixation: one or two screws or Kirschner wire
Correction range: mild to moderate deformity

Lapidus procedure (first TMT joint fusion)

Best suited for: Severe deformity or hypermobility at the first tarsometatarsal (TMT) joint.

The Lapidus procedure addresses the joint at the base of the first metatarsal rather than the metatarsal bone itself. The joint is fused in a corrected position, eliminating the instability that drives the deformity. This approach aims to address the underlying biomechanical cause and may reduce the risk of recurrence in patients with hypermobile feet.

Incision: medial and dorsal incisions over the first TMT joint
Fixation: plate and screws across the fused joint
Non-weight-bearing period: typically 6 to 8 weeks post-operatively
Note: longer initial recovery than other techniques due to the bone fusion process

Technique selection is based on your X-ray findings, joint condition, deformity severity, and recovery goals. During your consultation, our surgeon will discuss the most appropriate treatment options for your condition and explain the considerations behind each approach. No single technique is suitable for every patient.

Recovery and What to Expect

Understanding recovery is an important part of making a treatment decision. The information below provides general guidance only. The surgeon will provide a personalised recovery plan based on your specific procedure, overall health, and lifestyle.

Recovery comparison — at a glance

Phase	MIS (SPEAR plate)	Open surgery (Scarf/Chevron)	Conservative care
Weeks 1–2	Post-operative shoe; limited weight-bearing; foot elevation	Boot or cast; non- or limited weight-bearing; elevation	Footwear modification; activity modification; padding
Weeks 3–4	Progressive weight-bearing; physiotherapy begins	Protected weight-bearing begins; dressing care	Physiotherapy; orthotic fitting; stretching
Weeks 5–6	Transition to wider everyday footwear may be possible for some patients	Continued boot; progressive walking	Many patients experience symptom improvement
Weeks 8–12	Most daily activities resumed; physiotherapy ongoing	Transition to wider footwear; physiotherapy ongoing	Return to activities as tolerated
Months 3–4	Return to low-impact sport and leisure may be possible	Return to regular footwear; strengthening	Gradual return to higher-impact exercise as symptoms allow
Months 4–6	Return to running and sport may be possible, depending on healing and rehabilitation progress	Return to low-impact sport may be possible for many patients	Ongoing symptom management with appropriate footwear and self-care

After MIS bunion correction (SPEAR plate) — detailed milestones

Weeks 1 to 2: A post-operative dressing and specialist surgical shoe or boot are worn. Weight-bearing is limited according to the surgeon’s instructions. Elevating the foot helps control swelling. Wound checks are scheduled during this period.
Weeks 3 to 4: Graduated weight-bearing begins. Walking distance is progressively increased in the post-operative shoe. Physiotherapy may begin to restore toe movement and foot strength.
Weeks 5 to 6: Transition to wider, accommodating everyday footwear may be possible for many patients. Swelling typically continues to reduce.
Months 2 to 3: Most patients gradually resume normal daily activities. Continued physiotherapy supports strength and range of motion. Follow-up X-rays may be performed to assess bone healing.
Months 3 to 4: Return to low-impact activities such as swimming or cycling is typically possible. Running and high-impact activities depend on individual healing and your surgeon’s advice.

After open bunion surgery (Scarf, Chevron, or Lapidus) — detailed milestones

Weeks 1 to 2: Post-operative dressing and surgical footwear are worn. Foot elevation is particularly important. Wound care and dressing changes are carried out as directed.
Weeks 3 to 6: Progressive weight-bearing begins in a surgical shoe, as advised by your surgeon. Physiotherapy may begin during this period. Swelling and bruising typically peak around 2 to 3 weeks before gradually subsiding.
Weeks 8 to 12: Transition to normal-width footwear may be possible for many patients. Physiotherapy and strengthening exercises continue.
Months 3 to 6: Return to sport and high-impact activities depends on the specific procedure, healing process, and rehabilitation. Patients undergoing the Lapidus procedure often require a longer recovery due to the joint fusion process.

Recovery timelines are provided as general guidance only. Individual recovery varies depending on the procedure performed, your overall health, and your adherence to post-operative instructions. Our surgeon will provide personalised guidance based on your individual circumstances.

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What Happens If a Bunion Is Left Untreated?

Bunions do not resolve on their own. Without appropriate management, the deformity generally progresses over time, although the rate of progression varies between individuals. A significant bunion may be associated with the following complications:

Hammertoe or mallet toe

The big toe may press against adjacent toes, contributing to deformity of the second or third toe.
Metatarsalgia

Pain and inflammation across the ball of the foot as pressure distribution changes during walking
Hallux rigidus

Progressive arthritis of the MTP joint, which may lead to stiffness, reduced range of motion, and chronic pain
Chronic bursitis

Persistent inflammation of the fluid-filled sac overlying the bunion
Compensatory pain

Altered walking patterns may contribute to discomfort in the knees, hips, or lower back over time.

Bunions in Children and Teenagers

Juvenile and adolescent bunions have distinct characteristics from adult bunions. They often have a strong genetic component and may progress during periods of rapid growth, particularly in girls between the ages of 10 and 15.

Because the bones are still developing, management differs from that of adult bunions. Surgery is generally deferred until skeletal maturity, usually around 16 to 18 years of age, unless the deformity is severe and causing significant symptoms or functional limitation. Surgery performed before skeletal maturity may carry a higher risk of recurrence.

Conservative management during the growing years typically focuses on appropriate footwear, orthotics to help redistribute pressure where indicated, and regular clinical monitoring. Periodic X-rays may be recommended to monitor progression and guide treatment planning. Early assessment helps determine the most appropriate management and, if surgery is eventually required, the optimal timing.

If your child has been diagnosed with a bunion or you have noticed a developing deformity, an early consultation can help assess the condition and discuss appropriate monitoring and management during the growing years. Ask about our paediatric orthopaedic assessment when booking.

Reducing Your Risk

A close-up of a woman tying her running shoes in a gym setting, ready for a workout.

While an inherited foot structure cannot be changed, the following measures may help reduce the risk of a bunion developing or progressing:

Choose footwear with a wide, rounded toe box, adequate arch support, and heels below 5 cm
Maintain a healthy body weight to help reduce the load placed on the forefoot
If you have a family history of bunions or other foot problems, seek advice early if you notice symptoms or changes in foot alignment. Orthotics may be recommended where appropriate.
Address flat feet or overpronation with professionally prescribed orthotics where indicated
If your work involves prolonged standing, wear supportive footwear and take regular breaks where possible

Bunion (Hallux Valgus)

Frequently Asked Questions About Bunion Treatment in Singapore

Can a bunion be corrected without surgery?

Non-surgical treatment cannot reverse a bunion, but it can effectively manage pain and slow progression. Conservative options — footwear changes, custom orthotics, physiotherapy, and corticosteroid injections — address pain and inflammation without correcting the underlying bony misalignment. If conservative measures no longer provide adequate relief and the deformity is significantly affecting daily life, surgical correction may be worth discussing.

How long is the recovery after bunion surgery in Singapore?

Recovery after bunion surgery in Singapore typically ranges from 6 weeks to 6 months, depending on the technique. With minimally invasive correction (MIS with SPEAR plate), most patients return to wider footwear within 5 to 6 weeks and to low-impact sport within 3 to 4 months. Open procedures such as Scarf or Chevron osteotomy generally allow return to normal footwear within 8 to 12 weeks and return to sport within 4 to 6 months. Lapidus patients require a longer non-weight-bearing period due to joint fusion. Individual recovery varies, and your surgeon will provide a personalised timeline.

Is bunion surgery painful?

Surgery is performed under anaesthesia, and patients do not experience pain during the procedure itself. Post-operative discomfort is managed with prescribed pain relief and typically peaks in the first 3 to 5 days before gradually improving. Most patients find that discomfort is well-managed within the first two weeks. Swelling and tenderness around the foot can persist for several weeks as healing progresses.

Will a bunion come back after surgery?

Recurrence is possible after bunion surgery, although modern surgical techniques aim to reduce this risk. Wearing appropriate footwear, following post-operative instructions, and attending follow-up appointments may help support a good long-term outcome. The Lapidus procedure, which addresses underlying joint instability, may be associated with a lower risk of recurrence in selected patients with hypermobile feet. Your surgeon will discuss the factors most relevant to your individual situation.

What is minimally invasive bunion surgery, and how does it differ from traditional surgery?

Minimally invasive bunion surgery (MIS) uses small keyhole incisions rather than a single larger open incision to access and reposition the metatarsal bone. At ACME Orthopaedics, MIS is performed with the SPEAR plate system under fluoroscopic guidance. Because less soft tissue is disrupted, postoperative swelling may be reduced, and recovery may be faster in appropriately selected patients than with some open techniques. Traditional open surgery — such as Scarf or Chevron osteotomy — involves a direct incision along the side of the foot. Both approaches are effective; technique selection is based on clinical factors, not patient preference alone.

When is surgery the right choice for a bunion?

Surgery is appropriate when non-surgical options have not provided sufficient relief over a reasonable period (typically 3 to 6 months), when the deformity is significantly limiting daily activities or footwear choices, or when imaging shows a deformity that is progressing or is associated with symptoms and functional limitation. Surgery is not typically recommended for cosmetic concerns alone in the absence of functional impairment or pain.

Can teenagers have bunion surgery?

Bunion surgery in teenagers is generally deferred until the bones have finished growing, usually around age 16 to 18, because operating on immature bone carries a higher risk of recurrence. In most cases, conservative management with orthotics and footwear guidance is used during the growth years. Where deformity is severe and causing significant impairment, surgery may be considered earlier with appropriate patient and family counselling. An early consultation allows the condition to be monitored and surgery to be timed optimally.

Why Choose ACME Orthopaedics for Bunion Treatment?

Subspecialty orthopaedic care

Your ankle and joint conditions are assessed by a surgeon with focused subspecialty training in foot, ankle, and orthopaedic surgery.
Comprehensive, individual assessment

Your treatment plan is guided by your imaging findings, activity level, symptoms, and treatment goals.
Adult and paediatric capability

We provide assessment and treatment for both adults and children with a range of orthopaedic conditions.
Clear treatment discussions

We explain your treatment options, what each approach involves, the potential benefits and risks, and the expected recovery process to support informed decision-making.
Rehabilitation-focused care

Surgical outcomes depend substantially on rehabilitation. We work closely with physiotherapists to support your recovery from the first post-operative visit.
Accessible communication (24 hours)

Our team can be contacted by phone, WhatsApp, and email for appointment and treatment-related enquiries.
Continuity of care

Dr Zackary Chua oversees your care from consultation through treatment and follow-up, where appropriate.

Dr Zackary Chua (蔡克祥医生)

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (AUS)|MMed (Singapore)|MRCS (Glasgow)|FRCSEd (Orth)

Dr Chua is a Consultant Orthopaedic Surgeon with a subspecialty interest in foot and ankle surgery and paediatric orthopaedics. He is a member of the Singapore Orthopaedic Association and has completed fellowship training in foot and ankle surgery. He manages a range of conditions, including osteochondral injuries, ankle instability, hallux valgus, and paediatric musculoskeletal conditions.

Clinic: ACME Orthopaedics | Registration: SMC-registered | Languages: English, Mandarin