Understanding Hallux Valgus (Bunions)

Understanding Hallux Valgus (Bunions)

When the big toe begins to angle inward toward the adjacent toes and the joint at its base (the first metatarsophalangeal or MTP joint) begins to bulge outward, we call this condition hallux valgus — more commonly, a “bunion”. In essence:

• “Hallux” refers to the big toe and “valgus” means angling outward (from the midline of the body) or in this case the toe tilting toward the other toes.

• This misalignment leads to a bony prominence at the inner side of the big-toe joint, often causing pain, swelling, shoe-fit issues, and altered gait mechanics.

What causes it?

There is not just one cause; rather a mix of risk factors:

• Foot biomechanics: flat feet (fallen arches), over-pronation (rolling in of the foot) and structural predispositions can make the joint unstable and mal-align.

• Footwear: Narrow toe-boxes, high heels or shoes that crowd the forefoot increase pressure on the joint and force the big toe inward. La Tour+2Hallux Valgus+2

• Age, gender & genetics: Women are much more likely than men to develop bunions (about 9:1 ratio according to some sources). La Tour+1

• Professions or activities that involve prolonged standing, walking, or repetitive stress on the forefoot. La Tour+1

What are the symptoms?

Typical symptoms include:

• A visible bump at the base of the big toe (inner side of the foot)

• Pain, redness, or swelling around that joint — especially when wearing shoes

• The big toe leaning toward the second toe (sometimes even crossing over)

• Shoes becoming uncomfortable or no longer fitting properly

• Over time, there may be changes in gait, pressure transfer to other toes, and secondary issues such as calluses or bunionettes (on the little-toe side).

How is it typically treated?

For many people, the first line of management is non-surgical: modifying footwear, using orthotics or insoles, splints/slippers, exercises and pain relief measures. La Tour+2Hallux Valgus+2

Surgery is considered when there is severe deformity, significant pain unrelieved by non-surgical means, or when other complications appear. Hallux Valgus+1

It’s important to know: the non-surgical methods typically aim to relieve symptoms, slow progression, and correct or optimise biomechanics — they may not always fully reverse the deformity. Hallux Valgus+1

Non-Surgical Treatment with Dr. Michael Horowitz at Vancouver Orthotic Clinics

In Vancouver, BC, Dr. Michael Horowitz offers a comprehensive non-surgical approach to hallux valgus (and bunions more broadly) through his practice Vancouver Orthotic Clinics. Here’s a closer look at what sets his approach apart.

Background of Dr. Horowitz

Dr. Horowitz is a Doctor of Chiropractic (DC), graduating in 2000 from the Canadian Memorial Chiropractic College (CMCC) in Toronto. Vancouver Orthotics+1 His undergraduate studies were in biology and kinesiology (emphasis on fitness assessment and exercise counselling) at York University. Vancouver Orthotics Over time, he developed a special interest in foot-related issues and biomechanics — focusing on custom orthotic therapy as one of the key tools in his practice. Vancouver Orthotics+1

The 5-Step Process for Treatment

At Vancouver Orthotic Clinics, Dr. Horowitz offers what is described as a “unique 5-Step process” to address foot, posture and alignment-related issues (including bunions/hallux valgus). Vancouver Orthotic Clinics+1 While the exact step names aren’t fully detailed publicly, the process includes:

1. A detailed biomechanical assessment of the feet, posture and gait (including 3D foot scan, gait scan, etc). Vancouver Orthotics+1

2. Diagnosis of the underlying biomechanical faults causing or contributing to the bunion/hallux valgus.

3. Prescription of specific corrective measures — often custom orthotic inserts to correct foot alignment and relieve pressure at the big toe joint. Vancouver Orthotics+2Vancouver Orthotics+2

4. Recommendations on footwear modifications, exercise and possibly other adjunct therapies (soft tissue work, foot mobilization, corrective exercises) to support the correction and relieve symptoms. Vancouver Orthotics+1

5. Follow-up and adjustment over time: insert dispensing, adjustment, check-ins to ensure the orthotics are doing their job and the mechanics are improving. Vancouver Orthotics+1

How this approach helps hallux valgus

Here are some of the key ways in which Dr. Horowitz’s non-surgical approach works for hallux valgus:

• Custom orthotic inserts: These are prescription devices made specifically for the patient’s feet (via 3D scan or cast) that support arches, correct pronation, distribute pressure away from the big-toe MTP joint, and ideally reduce progression of the deformity. Vancouver Orthotics+1

• Footwear and biomechanical correction: By evaluating the patient’s footwear and walking pattern and recommending changes (wider toe-box, lower heel, supportive sole) the treatment helps reduce aggravating forces on the bunion. This is in line with broader conservative treatment literature. La Tour+1

• Exercise and mobilization: While orthotics treat alignment and load distribution, Dr. Horowitz also emphasizes getting at the source — muscles, tendons, joint mobility. For example, foot mobilization (to maintain toe joint mobility), toe-spacer use, strengthening of big-toe musculature are shown in research to help manage bunion pain and possibly reduce angles over months. Toronto Orthotics Clinic+1

• Whole-body alignment: Dr. Horowitz frames the feet as the foundation of posture. So by correcting foot mechanics you can also reduce compensatory stress higher up (knees, hips, back). This helps the body function better overall and relieves the foot from excessive load. Vancouver Orthotics

Realistic outcomes and expectations

It’s important to know what to expect from non-surgical management:

• For earlier or moderate hallux valgus, non-surgical methods can significantly relieve pain, improve function and reduce progression. Research shows combinations of joint mobilization, exercise and toe separators can reduce the hallux valgus angle in modest amounts over 3 months. Toronto Orthotics Clinic+1

• For severe deformities, non-surgical treatment may not fully reverse the misalignment — surgery might still be needed. As one review notes: “Although conservative treatments relieve symptoms, they do not achieve the same correction as surgery.” Hallux Valgus+1

• Compliance is key: The efficacy of orthotics, exercises and footwear modifications depends heavily on consistent use and follow-up.

• The goal is often to stop or slow progression, relieve pain, improve function and postpone surgery — not always to completely “un-bunion” the foot.

Why choose Vancouver Orthotic Clinics?

Here are a few reasons a patient might choose Dr. Horowitz’s practice for hallux valgus care:

• A foot-specialty focus: While many practitioners may treat foot pain, Vancouver Orthotic Clinics emphasizes custom orthotics, foot biomechanics and bunion/bunionette care specifically.

• Advanced tools and diagnostics: They employ 3D foot scans, gait scanning and biomechanical evaluation, which allow a more precise prescription of orthotic inserts. Vancouver Orthotic Clinics+1

• Customization: Orthotics aren’t “one-size-fits-all” — Dr. Horowitz prescribes individualized devices tailored to your foot shape, alignment and functional demands. Vancouver Orthotics+1

• Non-surgical emphasis: For individuals who wish to avoid or delay surgery, the practice offers a structured, biomechanically-driven approach.

• Accessible location in Vancouver: Convenient for Lower Mainland patients; online booking and evening or weekend appointments available. Vancouver Orthotic Clinics

Summary

If you’re dealing with hallux valgus — that inward-tilting big toe and outer-joint bump — know that you have more than just surgery as an option. Clinical literature supports non-surgical measures (footwear adaptation, custom orthotics, exercise, joint mobilization, load-management) especially in early or moderate cases.

Dr. Michael Horowitz at Vancouver Orthotic Clinics offers a structured, biomechanical non-surgical pathway: detailed assessment, custom orthotics, footwear and mechanical correction, exercise/mobilization and follow-up. While the treatment doesn’t always “undo” the deformity entirely, it can reduce pain, improve foot mechanics, slow progression and in many cases avoid or delay surgery.

If you’re interested, the next step would be scheduling an assessment with Dr. Horowitz, bringing your usual footwear, possibly imaging (if you have it) and discussing your goals (pain relief, improved comfort, avoiding surgery).