Do I Really Need Surgery for My Bunion? (Maybe Not!)

Dec 19, 2019

Let’s get this out of the way first. Yes, sometimes bunion surgery absolutely is necessary. There’s no way around this fact.

But the truth is that bunion surgery is necessary a lot less often than you might think. This can be especially true if you seek out our help early in the process—before your symptoms become too big to ignore.

And while surgical success rates are very high overall, it’s not a surprise that most patients prefer to avoid it if at all possible. Why go through an invasive procedure and 6 or more weeks of recovery if you don’t absolutely have to?

Good news: we have the same preference.

That might not be what you were expecting to hear from a foot surgeon, but it’s the truth. Ultimately, what we want is to free you from your pain and disability using the simplest, most convenient, and least invasive methods we possibly can. If we can get you back to living your best life without surgery, we will.

Conservative Treatment Can Alleviate Symptoms and Slow Progression

One caveat here before we go any further: Bunions are not reversible or correctable through any other means besides surgery. When we talk conservative treatment options, what we’re really talking about is relieving symptoms and, ideally, slowing or stopping the progression of the physical deformity—not restoring your foot shape.

Yet we do really want to emphasize the fact that conservative interventions, especially when begun in the early stages of a bunion, will usually allow you to stop the bunion from intruding on your lifestyle, and may prevent the eventual need for surgery—or at least delay it by many years.

Some of the non-surgical strategies that we have used to great success include:

  • Footwear choices. In general, you’ll want to stick with soft, wide, comfortable shoes as much as possible, as these will more easily accommodate the bunion and reduce the amount of pressure and friction acting on the deformity. Avoid wearing high heels, pointy-toed shoes, or other shoes that lack adequate support, cushioning, or wiggle room for the forefoot and toes.
  • Orthotics. We find that, in a lot of cases, the root cause of bunions is actually an inherited defect in foot shape, which places destabilizing pressure on midfoot bones and the big toe joint. The right pair of orthotics can address this by offloading weight and pressure, and even improving foot and ankle biomechanics. Not only will this reduce pain, but it may also significantly slow the progression of the bunion.
  • Friction reduction. Unless the joint has become severely arthritic, most of the pain of a bunion comes not so much from the bunion itself as it does from friction between toes, and between the bunion and the inside of your shoe. (This is why corns, calluses, and blisters are so common in people with bunions.) In addition to wearing wider shoes, this can often be addressed through things like strapping, padding, or toe splints.
  • Pain management. Depending on your situation, we may recommend over-the-counter autoinflammatory medications, foot soaks, stretches, massage, injection therapy, or even laser therapy as needed to manage painful symptoms.

By following these tips, as well as any other instructions we might recommend, the majority of our patients with bunions are able to keep the pain at bay and maintain their preferred lifestyle activities without too much difficulty, at least for a significant period of time.

Bunions on woman's foot

How Will I Know When Surgery Is Necessary?

That all being said, as we mentioned at the top of the blog, sometimes surgical correction of a bunion really is the only realistic choice. Even if you see us early and take all the steps listed above, your bunion still may slowly progress to the point that surgery is necessary.

The main indication for this is pain—specifically, pain that is occurring every day and keeping you from doing what you want to do. Sometimes in this scenario we will still recommend you try conservative options first; but if those don’t work well enough, we’ll likely have to move to the next step.

However, this should not be a cause for worry! While it’s true that we always prefer to avoid surgery if we can, success and satisfaction rates for bunion surgery are very high.

After most bunion surgeries, you can expect about 6-8 weeks of limited or restricted weight-bearing activity. However, clinical research and new surgical techniques are always improving, and you may be eligible for a procedure that features substantially less downtime. That’s a determination we’ll have to make in the office.

While surgery is always a last resort, we still think it’s a pretty easy call to make for most individuals. Two months of recovery may not sound like your idea of a great vacation, but coming out the other end with a pain-free foot and full return to activity is definitely worth it for the vast majority of our patients!

If you have a bunion, please don’t wait any longer to call Freeland Foot & Ankle Clinic. The sooner we can help you, the greater your chances of preventing or delaying the need for surgical care. You can contact us at (989) 695-6788, or request an appointment online.

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