When there are unbalanced forces on the foot and great toe, usually caused by a foot injury, rheumatoid arthritis, or improper footwear, your big or “great” toe may start deviating toward your other toes. This causes a bony bump to appear near the base of the great or small toe. The name of this condition is hallux valgus, but it iscolloquially referred to as bunions.

While wearing comfortable shoes and orthotic shoe inserts may help alleviate the symptoms, however these conservative methods won’t always give the desired effect. In this scenario, bunion correction surgery will be the only way. Here’s what you need to know about this surgical procedure and bunions in general.

How do bunions form?

Bones and joints in our feet are more delicate than they appear, and they only work properly when they have a great alignment. The problem is that this may notalways be the case. There are many reasons why bunions form:

• Bad footwear
• Genetics
• Foot injuries
• Rheumatoid arthritis

The biggest problem with bunions is that they cause pain and limit the mobility of your big toe. They may also make it difficult to wear some shoes (because they cause a slight foot deformity).

The symptoms of bunions are hard to miss, and after a while, it will become quite easy to self-diagnose. You’ll notice a:

•  Visible bump at the base of the big toe joint.
• Pain and tenderness around the joint.
• Swelling and redness around the affected area.
• Limited movement of the affected toe.
• Calluses on the bump of adjacent toes.
• The other lesser toes may raise up as the great toe deviates under them.

Bunions will usually worsen over time, and while wearing better footwear may alleviate the discomfort, bunion surgery is the only way to truly correct them.

Bunion correction without surgery

First, it’s important to mention that, even if they make the situation slightly better, these methods don’t completely eliminate bunions. Still, some of the methods that might help you are:

• Toe spacers and splints: Spacers are placed between the big toe and the adjacent toes. They can slightly improve the alignment making a small (but noticeable difference).
• Bunion cushions and padding: This reduces painful friction between your feet and the foot arch.
• Orthotic devices: These shoe inserts can support the foot arch, thus reducing the pressure on the affected area.
• Appropriate footwear: Shoes with ample space will not fix your bunion problems but ensure it doesn’t get any worse.
• Physical therapy: Believe it or not, some exercises can help strengthen the muscles, resulting in the improved alignment of the toes and your foot.

Still, you simply can’t skip discussing bunion correction surgery when looking at how to correct bunions.

Types of bunion correction surgery 

The key thing to remember is that bunion correction surgery is an umbrella term that can be used for four different procedures. You have:

• Bunionectomy: This minimally invasive type of bunion surgery involves the removal of the bony bump and realigning bones. A surgeon may release or tighten some soft tissues (if it’s necessary to correct the deformity) around the joint at the base of the great toe.
• Osteotomy: This procedure revolves around cutting and repositioning the bones, thus correcting the misalignment. This procedure has three subtypes – chevron osteotomy, scarf osteotomy, and Lapidus procedure.

• Arthrodesis: In this procedure, you are fusing the joint’s bones together to eliminate a potentially painful joint motion. This procedure is only used in the most extreme circumstances. You’re sacrificing joint motion for pain relief and foot/toe stability. In other words, this bunion correction surgery is used only as a last resort.

• Tendon repair: Sometimes, what it takes to fix the problem is the repair (or reconstruction) of the tendon.

Each of these surgeries takes a different approach to the same problem, meaning you need a professional to diagnose the problem. Also, the approach is often determined by the severity of the situation. Bunionectomy is the most common, followed by osteotomy bunion surgery. So, when we say bunion surgery, it’s usually these two that we’re referring to.

Is bunion surgery worth it?

This is the question that most people suffering from bunions want to know. Going to surgery is never an easy decision, so how do you know if you need bunion surgery and if this will make things better?

The answer is simple. You should consider bunion surgery if:

• You’re suffering.
• Non-surgical methods didn’t help.
• Your doctor recommends/suggests it.

It’s really hard to quantify the quality-of-life improvement from bunion surgery. However, according to some surveys, about 95% of patients would recommend it to friends and family after six months. In other words, the procedure does live up to the expectations.

Just remember that every situation is different and that the conditions and the level of deformity may also play a role in this.

How painful is the bunion surgery? 

In terms of pain levels, the surgery is performed under anesthesia. In other words, you won’t feel anything during the procedure, but you might feel some pain or discomfort after the procedure.

Often used in these types of surgeries is a regional block - where the anesthesiologist or surgeon - injects numbing medication around the nerves of the leg which supple the surgical site. These medications often last for 12 - 36 hours.

While it’s hard to quantify pain, most people find that they could have handled it with over-the-counter pain relievers that they’ve received after the surgery.

What is bunion surgery recovery time? 

You may return to normal activities and wear regular shoes in 6-12 weeks. The thing is that this also depends on the level of deformity before the procedure, as well as the bunion correction surgery type that you’ve just undergone.

The initial stage of recovery 2-4 weeks after the surgery is vital. You need to stay off that foot as much as possible during this period. If necessary, you should even use crutches. Some patients even can get a steerable knee scooter covered by their insurance company. 

Now, post-surgery, you also need to learn a thing or two about proper bunion self-care. Just because you’ve “fixed” the issue, this doesn’t mean that it could never happen to you again. Just learn how to choose proper footwear, relieve the stress on your feet by reducing your body weight, and start using some toe spacers or separators regularly. None of these is easy, but if you’re predisposed to developing bunions, it’s important that you follow this advice.

Wrap up

While many ways exist to alleviate pain, surgery is the only way to completely eliminate bunions. So, if you believe you can’t take it anymore and your doctor suggests surgery, it might be the best solution. Ultimately, even if you have a successful bunion correction surgery, you must always remain on the lookout. Otherwise, you’ll be back where you’ve started in no time.

Find a bunion surgeon at the Orthopedic Institute of New Jersey to learn more.