The Center for Podiatric Care and Sports Medicine

Should You Get Surgery For a Bunion, or Let It Be?

Posted by on Monday, May 30th, 2016

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If you go to a cosmetic foot surgeon and say, “This bunion is ugly. I want it gone,” no one will stop you. If you think it’s worth the pain and aggravation of surgery, plus a three to four-month recovery period, that’s your prerogative. But if you’re asking us – from a medical standpoint, as trained podiatric surgeons – if we feel you need surgery for your bunion, it’s another matter entirely.

should you get surgery for a bunion?
Should you worry more about the bunion or the bunion surgery? NY podiatrists discuss. (Image Source: Wikimedia CC user Liftarn)

What’s the Risk of Letting a Bunion Be?

Conservative estimates suggest 23% of 18 to 65-year-olds and 36% of those over 65 have bunions. A bunion is an outward protrusion at the base of you big toe joint. It’s a structural deformity, and not a “bone overgrowth” as some people mistakenly presume.

Mild bunions may not cause pain and may never worsen, particularly if you wear comfortable shoes and fix underlying biomechanical issues using orthotics or another simple method of treatment. However, a bunion is considered a progressive disorder, which means it will worsen without any treatment and will never simply vanish.

Possible side-effects of ignoring a bunion include the following:

  • Increasing inflammation and pain.
  • The development of calluses on the toe, which may open the body to infection.
  • The development of arthritis in the joint.
  • Difficulty moving the big toe or walking normally.
  • Significant changes to the structure and shape of the foot, such as the overlapping of the big and second toes.
  • Irritation of the fluid-filled sac cushioning the toe joint (a condition called “bursitis”).
  • Mental health changes due to ongoing pain, such as diminished vitality and social functioning.

What Are the Risks of Bunion Surgery?

Of course, the alternative – bunion surgery – is no walk in the park either. Generally speaking, up to 10% of people who undergo surgery for bunions say they’re left worse off than they were before. Complications may include:

  • Infection
  • Toe joint stiffness
  • Delayed or failed union
  • Deep vein thrombosis
  • Nerve damage and tingling
  • Pain under the ball of the foot
  • Chronic burning sensations
  • Under-correction that causes the bunion to return
  • Over-correction that causes the toe to drift in the opposite direction

As we’ve reported in the past, under or overcorrections are the most common complications. The nerve damage and residual pain most people fear actually account for less than 1% of all patients.

What Are the Best (Non-Surgical) Ways to Deal with a Bunion?

  • If the shoe fits, wear it! (If it doesn’t, don’t wear it!) When in doubt, bring that new pair of shoes to your podiatrist. We’re always happy to help patients with footwear questions. Sometimes, it’s just a matter of discovering which brands cater to your type of feet – be they wide, flat, or prone to bunions.
  • Try shoe inserts. It’s a common misconception that high heel shoes cause bunions. They certainly contribute to the progression of a bunion from bad to worse, but the root cause is believed to be genetic. We find that people with underdeveloped arches and flat feet are also more likely to have problems with bunions, so building a custom 3-D orthotic is something we really advocate for our bunion patients. We can make them quickly, easily and affordably in our NY office with our partner, SOLS.
  • For throbbing and aching, try the mainstays of podiatric care: ice and acetaminophen. It may sound simple, but popping an over-the-counter pain pill can go a long way toward taking the edge off. Applying a foot wrap with ice for 10-20 minutes at a time (as often as every hour, if needed) is another easy way to reduce the inflammation responsible for much of your pain.
  • Cushion the blow. During the summer, you may be able to get away with living in Fit Flops or some other type of comfortable sandal, but the fall and winter months – when closed toe shoes are a necessity for New Yorkers – can be rough. We advise adding moleskin, gel, or felt padding to high-pressure areas of your shoes to reduce rubbing.
  • Don’t be a one-trick pony. You may be a dedicated runner or absolutely love tennis, but changing up your routine goes a long way toward reducing the effect on your feet. Swimming and biking are great low-impact activities that do not contribute to the worsening of bunions.
  • Get down with “boring” exercise, too. Our NY physical therapy team can show you how to keep your joints aligned, your foot flexible, and your muscles strong. Briefly aligning your feet a couple times a day is one of the very best things you can do to prevent a bunion catastrophe. Simple activities like picking up marbles with your toes, curling them around a small towel, flexing them against a wall, or rolling a golf ball over the floor work wonders.

Contact our friendly sports medicine team if you have any questions pertaining to your bunion. We’d love to meet you!

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.