A bunion is a bony protrusion at the base of the big toe, resulting in pressure, swelling, and often intense pain. Bunions can result from congenital defects, excessive strain on the feet, or just tight shoes. Mild bunions can often be treated through over-the-counter or home remedies, but severe bunions can require medical treatment.
Bunions are permanent unless surgically corrected, and can lead to several serious complications: bursitis, a very painful condition in which the joints become inflamed; hammertoe, an abnormal bend in the second toe that causes severe pain; and metatarsalgia, the inflammation of the ball of the foot.
The best treatment for bunions depends on the severity of the deformation and the level of pain you’re experiencing. A good start is changing shoes. Finding shoes that are comfortable and allow plenty of space for the toes can alleviate many of the worst symptoms. Arch-support inserts can help as well. Taping or splinting can reduce stress on the toes, and anti-inflammatory medications such as acetaminophen, ibuprofen, and naproxen can help with pain and reduce inflammation. Icing might help as well, further reducing inflammation.
However, if these options do not work, surgery may be necessary. A surgeon can remove portions of a damaged joint, alleviate inflamed tendons, and realign the bones of your foot. But, long recovery periods, possible complications (including nerve damage), stiffening of the joints, and scarring should be weight as possible risks. Surgery is always a last resort, but if you’re experiencing intense pain, are having trouble walking and performing daily activities, have severe swelling—and you have tried orthopedic shoes, arch supports, and anti-inflammatory medications with no improvement, surgery may be for you.
You should weigh the risks and benefits with your doctor, who will review your medical history, and conduct any necessary tests to determine if you are healthy enough for surgery—an electrocardiogram to see if your heart is sufficiently healthy to cope with the stress of surgery and blood tests to test your liver and kidney function, which can effect the safety of anesthetics. X-rays will also be necessary to plan the surgery and evaluate the outcomes.
Recovery can take anywhere from two to eight weeks, and it is important to remember that relapses are common unless proper preventative measures are taken after surgery. Your doctor will give you instructions for caring for your foot at home. You may be given special footwear or even a cast to protect your foot. At home, the foot should be keep elevated to reduce pain and swelling. Your doctor may also recommend frequent icing and an anti-inflammatory medication. Walking should be kept to an absolute minimum. When walking is necessary a cane or walker may be necessary. Be sure to keep the dressing clean and dry, and follow up with your doctor regularly. Contact your doctor immediately if fever, redness, or swelling develops. After you have had some time to recover, your doctor may recommend physical therapy to recover your strength and range of motion in your foot.