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There is no exact cause of bunions. We do know that genetics has a role to play. Specific inherited foot characteristics like flat feet or overpronation increase the chances of developing one, which is why bunions tend to run in families.
Beyond that, people who habitually wear shoes that irritate their big toe may risk developing a bunion. High heels and narrow, pointed toe boxes are chief culprits. Other contributing factors may include foot injuries or inflammatory arthritis.
Although surgery is the only way to fix a bunion, it may not be the best treatment option for you if you can sufficiently reduce your deformity’s pain and pressure through other means. We like to think about bunion treatment as a three-stage process; we recommend starting with the first and only moving to the next when your current strategies aren’t providing enough relief.
Stage One: Home Care
If your bunion is small and only causing occasional pain, you can usually manage it with simple at-home care. The most critical component of treatment at this stage is footwear. Avoid high heels or narrow shoes, and instead stick with roomy, comfy shoes with a complete toe box and low heels.
Other steps to help minimize bunion pain at this stage include:
• Buy over-the-counter moleskin pads and place them on your bunions in the morning, before you put on your shoes.
• Soak your feet in warm water (along with some Epsom salt) at the end of a long day.
• Maintain a healthy body weight—more pounds equal more pressure on the feet.
Stage Two: In-Office Conservative Treatments
When home remedies aren’t working, we can help you with additional measures to manage the pain. The goal at this stage is to help you walk comfortably and enjoy everyday activities without impairment. Options include:
• Custom orthotics or special shoes
• Night splints
• Cortisone injections
• Physical therapy exercises to help maintain joint mobility.
• Removal of any existing corns or calluses
Stage Three: Surgery
Suppose you’ve tried the stage two treatments and are still experiencing pain that prevents you from living the lifestyle you want. In that case, it’s likely time to consider surgery. Severe bunions (such as those where the big toe has already started “crossing over” the second) will typically require this stage of treatment.
Surgical approaches may vary based on the nature and severity of the bunion. Common procedures include:
• Osteotomy: Bones in your big toe are cut, then realigned, and fixed in place with hardware (pins, screws, etc.).
• Exostectomy: The enlarged bony bump is removed. Since this does not realign the toe, it is usually combined with an osteotomy.
• Resection arthroplasty: The damaged, arthritic tissue in the big toe joint is removed, leaving an empty, flexible space that can bend like a joint.
Bunions only get worse with time, so don’t wait until the pain is excruciating, or you can’t fit into your favorite pair of shoes to seek help! Instead, call the Advanced Foot and Ankle Centers of Illinois. We have seven offices conveniently located throughout the Chicagoland area to serve you!
How long does a bunion procedure take?
Typical bunion surgeries take about 30-45 minutes to perform. Some larger bunions may take up to 90 minutes. The procedure is usually performed at a surgical center under twilight sedation, so no overnight stay is required.
Will my surgery need screws or plates?
Almost all bunion surgeries will need some screws, wires, staples, or plates. Generally, with an Austin/Chevron bunionectomy, one small screw is required.
Can I walk after bunion surgery?
For mild to moderate bunion surgeries, the patient can bear some weight on the surgically corrected foot the same day. For the first week, limited walking in surgical CAM boot is allowed. For severe bunions that need more extensive correction, there is no weight-bearing for 4-6 weeks.
Can I drive after bunion surgery?
After the procedure, due to the twilight sedation, driving is prohibited for 48 hours. After the initial 48 hours, if the surgery is performed on the left foot, no problem! Go ahead and drive! If it is on the right foot, that makes things a little more complicated. Driving in the walking boot is not allowed by law. We usually tell patients if their pain level is ok. They can transfer to a post-operative shoe to drive and then put the walking boot back on before walking. This is usually allowed after a couple of days.
How long do I wear the Walking boot after surgery?
For the typical bunion surgery, the boot is required for 2-3 weeks after the surgery. Then you can transition into a wider accommodating shoe.
When can I get back into regular shoes after bunion surgery?
The biggest issue after bunion surgery is swelling. You can usually get back into a gym shoe after 2-3 weeks as long as it accommodates the swelling and the post-operative splint. Swelling in the feet can last up to 6 months after surgery, so those high heels might have to wait a bit!
Is the surgery excruciating?
After surgery, you should rest, elevate, and ice your foot. Most patients need some form of pain medication for 3-4 days. These days are the most painful due to post-surgical inflammation. After that time, pain medication is usually not needed.
Can I have both of my bunions done at the same time?
No, is the short answer. I realize that it sounds appealing to get it over with, but it honestly is a bad idea. You need the right foot to walk on during the recovery process. I witnessed many complications in my residency when doing both bunions simultaneously and very few when doing just one. This is not a coincidence. One at a time is the best option and at least two weeks apart if you would like to get them both done ASAP.
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Disclaimer: The information provided was gathered from medical sources such as the Mayo Clinic, WebMD, The CDC, Kaiser Family Foundation, New England Journal of Medicine, The American Journal of Medicine, etc.
By reading this website, you acknowledge that you are responsible for your own health decisions. The information throughout this medical website is not intended to be taken as medical advice. The information provided is intended for general information regarding our Podiatry clinic in Brooklyn and the best Foot and Ankle Care Services. If you are interested in finding out more, avoid worrisome self-diagnosis, please contact our Podiatry specialist for a personal consultation. No information on this site should be used to diagnose, treat, prevent, or cure any disease or condition.