As an orthopedic doctor, I treat a range of foot and ankle conditions, including bunions. A bunion, also called hallux valgus, is a bony bump that develops on the joint at the base of the big toe. Pressure on the big toe – which is often caused by wearing tight, narrow shoes – causes it to push against the second toe. Over time, this kind of pressure can alter the toe’s bone structure and cause pain, swelling and redness. Bunions can also result from structural defects or other conditions, such as arthritis.
Nonsurgical Treatment Options
- Toe spacers/night splints – Pain relief can sometimes be achieved by simply taking the pressure off your bunion. This could mean custom or over-the-counter shoe inserts to space out your toes during the day, or toe splints to be worn at night.
- Proper shoe fit – Shoes that narrow toward the tip or squeeze too tight around the metatarsophalangeal joint (MTP joint) are a common cause of painful bunions. To prevent or alleviate bunions, make sure you have proper footwear. Wear shoes that have plenty of toe space and are the right fit for each foot (as your right and left foot could vary in size).
- Icing and anti-inflammatory medications – Swelling around the MTP joint, and the corresponding pain, may be reduced by icing the bunion for 20 minutes a day, or by taking nonsteroidal anti-inflammatory medications such as ibuprofen or naproxen.
If nonsurgical treatments and preventive measures prove unsuccessful, I typically recommend a bunionectomy, the surgical removal of a bunion. The type of bunion surgery varies from patient to patient, but typically involves realigning the bone and repairing the surrounding soft tissue. Some examples include:
- Osteotomy – The realignment of the big toe joint to a normal position
- Exostectomy – The removal of the bunion without realigning the big toe joint
- Arthrodesis – The replacement of damaged joints with screws and metal plates
As a precaution, I usually do not recommend the removal of a painless bunion for purely cosmetic reasons (to improve the appearance of the foot). If the bunion is not causing you pain, it is possible pain will develop in the joint once the bunion is removed.
Ask yourself some questions to evaluate your need for surgery:
- Am I old enough for bunion surgery? Surgery is not recommended for children or adolescents because they have not reached skeletal maturity, and there is a good chance the bunion could return.
- Am I willing/able to deal with a long recovery? Though many surgical treatments for bunions are outpatient procedures, proper healing may take a while. Typically, patients can return to normal activities after six to eight weeks, but could take between six to 12 months to fully recover from their surgery.
- Does the pain interfere with everyday activities? – If your bunion pain limits your movement or keeps you from participating in certain activities, such as walking, jumping or running, then you may be a good candidate for surgery.
If you have bunion pain and would like to discuss surgical and nonsurgical treatment options, contact our office for a consultation.
About the Author: James Halloran, M.D. is a board-certified and fellowship-trained orthopedic surgeon whose primary clinical interest focuses on diagnosis and treatment of conditions involving the knee, ankle, and foot. Dr. Halloran completed fellowship training in both sports medicine and foot/ankle surgery.
The medical information contained in the Dickson-Diveley Orthopaedics website is provided to increase your knowledge and understanding of orthopedic conditions. This information should not be interpreted as a recommendation for a specific medical or surgical treatment plan. As each patient may have specific symptoms or associated problems, the treatment regimen for a specific patient may not be the proper treatment for another.
Gaining knowledge and understanding of a particular problem or condition is the first step in any medical treatment plan. I believe the information presented on our website will be helpful for those individuals experiencing ankle pain, or other related problems. However, this information is not intended to replace the advice of your family physician. You are encouraged to consult with your physician to discuss any course of treatment presented or suggested.