BunionIf the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion.

More than half the women in the UK have bunions, a common deformity often blamed on wearing tight, narrow shoes, and high heels. Bunions may occur in families, but many are from wearing tight shoes. Nine out of ten bunions happen to women. Nine out of ten women wear shoes that are too small.

Too-tight shoes can also cause other disabling foot problems like corns, calluses and hammertoes.

With a bunion, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. An advanced bunion may make your foot look very deformed. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.

Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, never force your foot into a shoe that doesn’t fit. Choose shoes that conform to the shape of your feet. Go for shoes with wide insteps, broad toes and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 1/4 inches. If you already have a bunion, wear shoes that are roomy enough to not put pressure on it. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You may also try protective pads to cushion the painful area.

If your bunion has progressed to the point where you have difficulty walking, or experience pain despite accomodative shoes, you may need surgery. Bunion surgery realigns bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. Orthopaedic surgeons have several techniques to ease your pain. Many bunion surgeries are done on a same-day basis (no hospital stay) using an ankle-block anesthesia. A long recovery is common and may include persistent swelling and stiffness.

What is bunion surgery?

Bunion surgery is a surgical procedure to remove bunions. Successful bunion surgery can reduce the discomfort and pain bunions cause.

If you see a bony bump near the base of your big toe you may very well have a bunion. Anyone can develop a bunion but interestingly bunions seem to be more common in women than in men. There is a suggestion this may be down to the footwear we wear.

What are the benefits of bunion surgery?

Bunion surgery will correct the foot and remove bunions. A bunion is a bony lump on the side of the foot at the base of the big toe. The most common cause of bunions is footwear that does not have enough width to fit the toes in their natural position. They are occasionally associated with arthritis of the joint at the base of the big toe.

Following bunion surgery your big toe should be straighter, so your foot should fit more comfortably in a normal shoe.

What will happen during my bunion surgery consultation?

When you meet with your consultant surgeon they’ll ensure that you have the opportunity to ask any questions you may have about your bunion surgery, they’ll discuss with you what’ll happen before, during and after the procedure and any pain you might have. Take this time with your consultant surgeon to ensure your mind is put at rest. We know that having an operation of any type can be stressful so we’ve created a short downloadable guide that you might find useful to print off and use to write down any questions you may have. Do take this with you to your consultation.
Are there any alternatives to surgery?

The main alternative to bunion surgery is to adapt your shoes so that they fit comfortably.

What does the operation involve?

A variety of anaesthetic techniques are possible. The operation usually takes between half an hour and an hour.

The bunion surgery may involve removing the bunion, releasing or tightening ligaments, cutting and realigning the bones of your big toe and straightening one or more of your smaller toes.

Your surgeon may fix the toes in place with wires or tiny screws.

What complications can happen?

General complications of any operation

  • Pain
  • Bleeding
  • Infection in the surgical wound
  • Unsightly scarring
  • Blood clots
  • Difficulty passing urine

Specific complications of this operation

  • Damage to nerves around the big-toe joint
  • Problems with bone healing
  • Loss of movement in the big toe
  • Severe pain, stiffness and loss of use of the foot (Complex Regional Pain Syndrome)
  • Pain in the ball of the foot
  • Recurrent deformity

How soon will I recover?

You should be able to go home the same day or the day after.

For the first week following bunion surgery you will need to spend most of the time with your leg raised up so that the swelling settles.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.

It can take six weeks or longer before the swelling has gone down enough for you to wear a normal soft shoe.

Summary

If you have a bunion that is causing pressure and pain, surgery should straighten your big toe and make your foot fit more comfortably into a normal shoe.

If you have a painful swollen lump on the outside of your foot near the base of your little toe, it may be a bunionette (tailor’s bunion). You may also have a hard corn and painful bursitis in the same spot. A bunionette is very much like a bunion. Wearing shoes that are too tight may cause it. Get shoes that fit comfortably with a soft upper and a roomy toe box. In cases of persistent pain or severe deformity, surgical correction is possible.