Bunion treatment options – with or without surgery?

Surgery may or may not be one of the viable bunion treatment options but there is no kicking this into the long grass, bunions are problematic to treat. They can be irritating, they can make you stop wearing the footwear of your choice, and they can make you change the way you walk. And changing the way you walk, your gate, can have other knock on effects with your body.

Thankfully, there are a number of ways of working around the problem of bunions, even if the only way to get rid of them is surgery; but read on and we will explain some more.

When to see a Foot Specialist (Doctor or Podiatrist)?

Often bunions require no treatment, however see a specialist if there is:

• Continual big or small toe pain that stopping normal activities.
• An obvious lump on the big or small toe joint.
• Decreased movement of the big or small toe.
• Footwear does not fit properly because of a lump.
• An underlying diagnosis of diabetes, as foot issues have raised consequences for diabetics.

A specialist can confirm if a bunion is present by examining the foot. An Ultrasound, X-ray or MRI Scan of the foot may be required to assess the bunion’s severity. A further referral may be made to a surgeon if the bunion is very painful, or having life affecting consequences. In the NHS this is generally considered if:

• The bunion is really painful and is getting worse.
• The second toe is also affected by the bunion.
• There is a difficulty finding any shoes to fit, and the bunion is severely affecting day-to-day life.

If the bunion is not referable by any of these criteria and there is a concern over how the bunion looks, private treatment may be considered.

How to treat a Bunion without surgery?

There are non-surgical bunion treatment options available that can reduce the pressure on the bunion, and relieve the pain. These include:

• Good fitting footwear: Wearing roomy, comfortable shoes that are wide in the toe area. As a rule shop where they will measure the width of your feet first and provide appropriate footwear.
• Using pads, tapes and/or splints: Making use of moleskin or gel-filled pads, and with specialist advice; taping the foot in a normal position, or wearing a splint overnight that can hold the toe straight.
• Taking medications: Taking anti-inflammatory drugs (e.g. ibuprofen) may reduce pain and swelling. Cortisone injections may also be used to relieve swelling, particularly in the fluid-filled pads that cushion the bones. A specialist will advise about these drugs.
• Using Shoe inserts: Using padded shoe inserts may distribute pressure across the foot. These may be over-the-counter inserts, but some may need a specialist prescription.
• Cooling and or soaking: Icing a bunion if it becomes inflamed can help relieve soreness and inflammation. Alternatively relief may be provided by warm soaks, ultrasound and massage.
• Managing weight: Maintaining a normal weight will naturally put less pressure on the foot.
• Avoiding painful activities: Reducing activities that cause pain such as standing for a long period of time, or playing intense sports.

How is a bunion treated surgically?

The surgery performed will depend on:

• The level of deformity.
• The severity of the symptoms.
• The patients age.
• Associated medical conditions.

Bunions have a number of surgical procedures, no single technique is a universal solution. Procedures may involve:

• Cutting away the swollen tissue from around the toe joint.
• Removing part of the bone to straighten the toe.
• Realignment of the long bone that connects the back of the foot to the toe, to correct the angle in the toe joint.
• Fusing the bones of the toe joint permanently.

Depending on the procedure walking may be possible immediately, though full recovery can take weeks to months. Normally to avoid a recurrence suitable footwear will need to be worn afterwards.

There are some possible complications after surgery, these can be summarised as:

• Stiffness in toe joints.
• Slowness or failure of the bone to heal, or healing with a misalignment.
• Painful ball of the foot.
• Nerve damage in the foot.
• Swelling and/or continued pain.
• Further surgery as the bunion has returned.