What is a bunion? And other common questions about bunions

Summer feet

Sandal season is finally here, which means many of us are thinking about our bare feet for the first time in months. While it feels great to liberate our feet from socks and boots, unpleasant foot issues like bunions are potentially on display as well.

Bunions can cause a great deal of discomfort. In severe cases, bunions can make walking — or even wearing shoes — extremely painful. Patients often ask me what they should do about their bunion issues so I wanted to share some information on the treatment options you have and how bunions may impact your life.

What is a bunion, and what causes bunions?

A bunion is caused by a gradual change in the position of the bones that make up the big toe. It makes the bones stick out more on the inside part of the big toe. It is not a "growth" or callus.

What are my options for bunion pain relief?

The best way to alleviate bunion pain is to avoid shoes that make the pain worse. Usually shoes that are wider at the toes or open-toed (weather permitting) are best. Splinting or bracing the toes will not affect how the bunion changes over time. Unless you also have other issues with the shape of your foot, custom insoles are not usually helpful for bunions either.

How to get rid of bunions

Bunions can be corrected surgically when you are no longer comfortable wearing any kind of shoes and the pain interferes with your daily activities. Bunion surgery is not a good idea just to improve the appearance of your feet because of the inherent risk involved with any surgery. The potential benefit of undergoing the surgery needs to be greater than the risk.

How does bunion surgery fix my feet?

Surgery fixes bunions by realigning the bones to make the foot narrower so the bunion doesn’t stick out as much. We also remove a small amount of bone on the bunion area and adjust the surrounding soft tissues so they stop pulling the bones in the wrong way.

There are many different surgeries for correcting bunions. The technique that is best for you and your foot depends on many factors including the size of the bunion and whether there is also any arthritis of the toe. The best way to determine which procedure is best for you is to have a discussion with your orthopaedic foot and ankle surgeon about your options after having X-rays.

How long is recovery from bunion surgery?

All bunion surgeries require at least two weeks of minimal activity and keeping the foot elevated to control swelling and promote wound healing. After those first two weeks, the recovery time will depend on the surgery that was done. Most commonly, you would not be allowed to walk fully on the foot for two to six weeks. Most people are able to start wearing a regular shoe approximately two months after surgery as it takes time for the swelling to resolve.

Can bunions come back after surgery?

Typically, bunions do not come back after surgery. However, in rare instances your bunion can resurface. If the bunion comes back, your surgeon would have to look for a reason why this happened. For example, if the bone did not heal in the correct position or the initial surgery did not fully correct the bunion.

Is it possible to wear high heels again after undergoing bunion surgery?

There is no guarantee as to which shoes you will be able to wear after bunion surgery. For most bunion surgeries, if appropriate stretching is done and the motion of the big toe gets back to normal, you should be able to wear a variety of shoes -- possibly including a heel. But the goal of wearing high heel shoes again should not be the only reason to have bunion surgery.

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Kelly Hynes, MD

Kelly Hynes, MD, specializes in the diagnosis and treatment of foot and ankle conditions, including trauma, sports injuries, forefoot deformity and degenerative disease.

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