Bunions are slowly worsening and, eventually, quite painful bony deformities that begin to bulge out along the inside of your foot, from the base of your big toe.
They may start small, but over time bunions get larger and worse. At the same time, the big toe drifts out of alignment in the opposite direction—sometimes crashing into, or even crossing overtop of, the second toe.
Anyone who has ever had one can tell you they’re as uncomfortable as they look. A prominent bunion can make wearing ordinary shoes a painful nightmare, and you may even develop corns and calluses in pressure zones.
But not to worry! Our team can provide effective treatment remedies. And the sooner you seek help, the more likely we can manage the pain effectively without surgery.
What Causes Bunions?
It’s not always immediately clear what causes a given bunion. However, we have a pretty good understanding of the risk factors, and they include elements of both nature and nurture.
- Nature. Bunions do tend to run in families. Unfortunately, the foot structure or walking gait you inherited from mom and dad might make you more prone to developing a bunion, if your feet aren’t able to efficiently keep excess weight and pressure away from the big toe joint.
- Nurture. Environmental factors are also linked with bunions. Some of the most common include wearing tight shoes or high heels, sustaining accidental injuries to the toe, or even developing chronic conditions like rheumatoid arthritis.
Bunion Treatment Options
There are two broad treatment options for bunions—you can either do your best to manage the symptoms and slow down the rate the bunion progresses as much as possible, or you can get it corrected surgically.
There are pros and cons to each approach, but the longer you wait to get treatment, the less likely conservative management protocols will be effective, and the more likely you are to need surgery.
Obviously, then, we strongly encourage you to seek us out as soon as you notice a bunion beginning to form, rather than waiting for symptoms to worsen. The more proactive you are, the more options we’ll have to help you.
We always prefer to manage bunions conservatively whenever possible. The main goal is enabling you to live your life to the fullest without pain, and if we can do that without putting you through surgery, we will.
Conservative treatment options include:
- Ditching your heels and other impractical shoes in favor of roomier, supportive, and comfortable pairs that give your toes wiggling space.
- Nonmedicated bunion pads, which help reduce friction on the bunion and prevent the formation of painful corns.
- Taping and/or splinting the toe back into proper alignment, if the joint is flexible enough to do so.
- Shoe inserts or custom orthotics that help redistribute weight, support your feet, and reduce pressure shocks on the unstable toe joint.
- Temporary pain relief medications as necessary, including oral medications or steroid injections.
Surgical reconstruction of the forefoot may become necessary if conservative therapies are no longer providing adequate pain relief from daily living or favorite activities.
The vast majority of bunion surgeries we do are performed outpatient at our office, under ankle block anesthesia. You will be able to return home the same day, after a couple of hours recovery.
Depending on the severity of the bunion as well as your medical history, long-term lifestyle goals, and other factors, one or more reconstructive surgery procedures will be selected. These might include:
- Simple removal of swollen soft tissues around the deformed joint.
- Repairing or transferring tendons and ligaments supporting and surrounding the misaligned toe joint, in order to help straighten out the toe (and keep it there).
- Trimming and removing excess enlarged bone at the base of the toe joint. This is called exostectomy, or sometimes just a bunionectomy.
- Cutting and removing “wedges” of toe bones so that they can be realigned to lie straight (osteotomy).
- Fusing one or more joints in the toe (arthrodesis). This permanently prevents motion in that joint, but also very reliably reduces pain and prevents relapse.
- Removing the damaged portions of the joint and leaving a flexible “joint space” made from scar tissue (resection arthroplasty).
The osteotomy with tendon transfer or repair is, generally speaking, the most common approach. However, more mild bunions may only require an exostectomy, while older patients with more severe or recurring bunions may benefit more from arthrodesis or resection arthroplasty.
We always make surgical decisions on a case-by-case basis, after reviewing all your options with you and making sure you understand the risks, benefits, and drawbacks of each.
Bunion Surgery Recovery
Most people are very satisfied with their bunion surgery results, and are able to make a complete return to regular activities in a reasonable timeframe.
At first, your foot will be swollen and somewhat sore, and you’ll need to protect the surgical site and avoid bearing weight for at least a couple of days. We’ll also provide instructions on how you can reduce the risk of infections.
We will provide a special surgery shoe, walking boot, etc. as necessary to keep you from bending the toe joint as it recovers. Depending on the type of procedure, you can expect to be back in normal shoes anywhere from a few weeks to a few months.
Individual results vary, but full recovery takes 4-6 months on average. That said, return to full activity is generally sooner than that. In any case, the more disciplined you are about following all of Dr. Patel’s post-surgical instructions, the faster the recovery process can go.
The Best Bunion Care in Connecticut
So, are you finally ready to do something about your bunions? (If you have them at all, the answer should be yes!)
To schedule an appointment with Dr. Sanjay Patel and the team at Family Foot Care & Surgery, please call our offices in Milford and Hamden at 203-876-7736.