Bunions are bony, abnormal bumps that form on the joint beneath your big toe or pinky toe. (When that happens, we call them tailor’s bunions, or bunionettes). Now, they can be troublesome, no doubt. For one, they can cause discomfort, particularly when your shoes press up against them. On that note, they can make it harder to find a well-fitted pair of shoes. And, of course, they can grow bigger and bigger. At which point, your only treatment option is surgical removal.
But…surgery is not the only answer to your bunion problem. (That's especially true if you seek treatment as soon as the condition starts to develop!). So, today, we'll review all your treatment options for bunions. But we'll also review the 3 times when you SHOULDN’T opt for bunion surgery.
3 Reasons to Skip Bunion Surgery
- Your bunion is small. We can treat smaller growths conservatively. That may mean changing your shoes, padding your bunion or wearing special shoe inserts. (We'll review these options soon.) These early interventions can stop bunion growth in its tracks. But they can't get rid of any bump you've already got.
- You are not in pain. If your bunion isn't affecting your ability to walk, run or exercise, chances are you don’t need surgery!
- Your only problem is that your shoes don’t fit. Remember, it’s a lot easier to invest in a new pair of shoes than it is to undergo an operation. Because, as I'll explain soon, bunion surgery comes with a not significant recovery period.
What Happens During Bunion Surgery?
I just told you when to say no to bunion surgery. But sometimes, it's your only choice. And that's true if conservative measures no longer give your relied from bunion surgery.
Remember, I never recommend bunion surgery for cosmetic reasons. But if you bunion makes walking or wearing shoes hurt, it may be time for surgery.
Now, bunion surgery isn't a one-procedure fits all situation. In fact, there are many different procedures to correct a bunion. And we decide your best option by giving your foot an x-ray. (Luckily, in my Houston podiatry practice, we've got in-office x-rays for your convenience!)
Once I can tell how rotated your bones appear to be, we'll talk a bit more. I'll help you explain the main sore spot on your foot. Then we'll decide the best procedure to reposition your metatarsal bone. And to straighten your big toe.
After bunion surgery, you won't be ready to put weight on the area for a while. But what that looks like will depend on the type of surgery we performed. If you had stable bunion surgery, where I lightly shaved your bump, I may give you a walking boot right after your procedure. That will help you get around without compromising your recovery.
But if I have to move your metatarsal bone? Your foot will be less stable after the surgery. In that case, casts, crutches or scooters could be the name of your post-op game. And, no matter what, you should expect to take a break from regular exercise routines for several weeks after your surgery. Which is why, you should never say yes to bunion surgery if you haven't looked at other treatment options.
Minimally Invasive Bunion Treatments
One of the best ways to stop bunion growth is to change your shoes. Your first priority? Make sure the pairs you wear fit your feet. That's the only way to keep your shoes from making your bunions worse. Key features to look for? Lots of room in the toe box to stop pressing on your bunion.
Plus, you'll want to spend a lot less time in high heels. After all, they more pressure on the front of your foot. Which puts more pressure on your bunion. And, if you've already got a stiff toe joint, those heels will just make the problem more painful.
Pads and Cushions
Another option I use for small bunions is padding. This is a great choice if your pain radiates from the bump of your bunion. And guess what? Non-medicated pads do the job well, since they keep your shoe from rubbing your bunion uncomfortably. Often, after padding, you can get back to wearing your old shoes. Pain free, as long as they aren't the wrong style for bunions.
You've probably seen these devices in the drug store. Maybe you've even worn one, thinking they'll correct your bunion without surgery. But I don't endorse these OTC bunion treatments.
In my experience, all they do keep your big toe away from the other ones. Now, this may relieve stiffness and some of your pain. But it won't make your bunion bump smaller. Or correct the underlying issues, such as pressure and your body structure, that made the bunion grow in the first place.
Sometimes, you only need to manage your pain, not your bump. I'll often recommend:
- Over-the-counter anti-inflammatories, such as ibuprofen
- Daily icing sessions (no longer than 20 minutes) to reduce your inflammation.
- Cortisone injections to reduce the inflammation. I'll often recommend an injection if you've also got a fluid buildup (bursitis) over your bunion.
You develop a bunion when your foot mechanics weaken. So, if I can make your foot more stable with a custom orthotic, your bunion won't get worse. Of course, it won't disappear, but it shouldn't grow or cause more pain.
Part of you custom orthotic fitting includes an extensive biomechanical examination. That's how I can identify what's causing your bunion growth.
Then, once that's done, I'll take a mold of your foot. That lets me design the right kind of orthotic to balance your feet. It also counters the forces pushing on your bunion. So that, if you do decide to get bunion surgery, it won't come back later.
Yes or No: When to Choose Bunion Surgery
Hopefully, you've learned about non-surgical bunion treatments. And you know when NOT to operate on a bunion. So let’s go back a step. And talk about when you should ask for surgery.
Explore bunion surgery if you're very uncomfortable. Or if your bunion keeps growing. Even after trying non-invasive treatments.