Bunion Surgery - Faster Recovery,
Less Pain

Gregory J. Mack, DPM, FACFAS
Podiatry, Foot & Ankle Clinic, LLP

A bunion is a painful deformity of the joint at the base of the big toe. It is caused by the big toe moving out of place, toward the other toes. A large bump forms on the bone at the big toe joint and can become inflamed and painful. This particular joint bears the majority of your body weight during walking and daily activities. As the big toe joint becomes more mal-aligned (crooked), discomfort increases and may affect a person’s ability to walk without pain. The bunion changes the shape of the foot and can make it very difficult to wear shoes or walk.

Bunions form over a long period of time. Tight or improperly fitting shoes, high heels over 2 inches, the way a person walks or inherited characteristics can change the normal mechanics of the foot and the way it works. The foot may flatten allowing the big toe joint to move above and beyond its normal range of motion. If this misalignment of the joint is allowed to continue, the chance of developing an arthritic condition within the big toe joint increases, causing pain. Some people are born with bunions. If these deformities are recognized early in life, they can usually be repaired before joint damage occurs. When a person is at risk of developing bunions due to a strong family history or trauma, wearing inappropriate or high heeled shoes will definitely make the problem worse.

Treatment Options

The help of a podiatric specialist should be sought at the first sign of pain or change in the foot’s shape. Early diagnosis and treatment can help reduce pain and swelling and stop the growth of the bunion before corrective surgery becomes necessary. There is more than one type of bunion. Positional bunions have to do with mal-alignment of tendons and enlargement of the big toe joint itself. Structural bunions occur when the space between the first and second metatarsal bone increases resulting in the gradual dislocation of the joint. To determine the type of bunion and the best option for management of the condition, x-rays and a physical exam are required. Often the pain and pressure of a bunion can be treated without surgery with a well designed custom molded insert and/or changes in the kind of shoe being worn. Long-term anti-inflammatory or other pain medication usage is rarely considered to manage a bunion deformity. If conservative treatment fails, then surgical intervention should be considered.

The severity of the bunion will determine the surgical procedure. Sometimes the bunion can be repaired by realigning the soft tissue and taking out the excess bump. More common, however, is a bone shifting procedure where a surgical cut is made in the bone and the joint is realigned to reduce the space between the first and second metatarsal. Bunion surgeries are usually done in an out-patient setting using light sedation and a local anesthetic. The procedure takes about 30-45 minutes to complete. Patients are usually able to walk the same day, and return to wearing their regular shoes within 4-6 weeks.

Severe bunion deformities require a more aggressive procedure. The bone is cut farther back on the metatarsal to reduce the deformity. Screws and often staples are used to hold the bone cut in place. This procedure requires 6-8 weeks in a cast and the use of crutches. With these new bunion surgery procedures, a person should expect the big toe joint to be in significantly better alignment and its function greatly improved. With the pain reduced, people are able to enjoy renewed mobility and an improved quality of life.

In the past, bunion surgery tended to be extremely painful and very debilitating. With modern surgical procedures the problem can be repaired, pain reduced and people can walk the same day. Not all bunions need to be repaired. If there are no symptoms, intervention is usually not needed. If a bunion requires surgery, patients can expect excellent results.

For more information or to schedule an appointment in Menomonie, or at one of 9 outreach clinic locations in the Chippewa Valley, contact Gregory J. Mack, DPM, FACFAS, Foot & Ankle Clinic, LLP, » 800.359.4421.