You've heard of bunions, maybe you even have one or two yourself. These unsightly protrusions can cause pain, difficulty in finding comfortable shoes and foot wear and even problems with walking. A bunion, also know as hallux valgus, is a (sometimes painful) bony bump that develops on the inside of the foot at the big toe joint. Bunions develop over time. Pressure on the big toe joint causes the big toe to lean toward the second toe, which causes the deformation of the foot. Bunions are more common in women, but men can also get bunions. There are many causes of bunions, and yes, even including wearing high heels or tight, narrow shoes. However, most often, bunions develop as a result of an inherited structural defect, stress on your foot or a medical condition, such as arthritis.
The good news is that almost all bunions can be fixed surgically. Most foot and ankle surgeons will tell you that they only recommend surgery for painful bunions, or bunions that are affecting your daily lifestyle. The reason for this is because with any surgery there are risks to your overall health and by changing the structure of your feet, you could end up with pain post surgery that you didn't have before surgery. Proper evaluation by a foot and ankle surgeon is a must before deciding to do bunion surgery.
Although surgery is the only way to remove a bunion, there are a lot of ways to relieve bunion pain without stepping foot into an operating room. For example, you could wear wider and more comfortable shoes , have steroid injections performed or place pads or orthotics in your shoes to cushion the bunion and reduce pain. If you've tried all of these things and you've decided to move forward with your bunion surgery, here are a few common questions that are asked about bunion surgery.
- Is it painful? Every person has a different pain tolerance. Pain following any surgery - including bunion - can be managed with medication and other treatment options like physical therapy, cold application, etc. Since every person tolerates pain differently, what may be "extremely painful" for one person may just be moderately uncomfortable for another.
- Can bunions grow back? It's possible. Extremely unlikely and rare, but not unheard of. It's possible if you happen to have what is known as excessive motion of the foot, predisposing you to bunion reformation, or that the surgery chosen was not the best fit for your particular bunion. It's important to work with an experienced podiatrist to ensure all treatments - especially surgery - are tailored to your needs.
- Do I have to be in a cast? It depends on the severity of your bunion and while this was true years ago, more modern techniques have allowed surgeons to mobilize patients faster. Mild bunions typically involve walking in a surgical shoe or boot for six weeks. The reason surgeons consider casting with crutches with larger bunions is because setting the bones is more complex. There are many types of bunion procedures including not doing bone cuts and instead performing a fusion procedure that allows for realignment of the entire deviated bone. This fusion procedure is called the Lapidus Bunionectomy. If you are a candidate for this procedure, you could be walking at two weeks postoperatively. Recent technological advances in medical implant devices have also helped surgeons modify their techniques to get patients moving faster.
- Do I have to take months off of work? The simple answer is no, but it really depends on the demands of your workplace. It's possible a patient can return to a sedentary desk job within two weeks of the surgery, however, it varies based on surgeon protocol and type of bunionectomy performed. If you have a job that requires a lot of walking, standing and physical activity, your healing process may require a medical leave of absence -- which can be up to two months. Also if you have a job that requires excessive driving and your bunionectomy was performed on your right foot, there may be an extended medical leave of absence.
Dr. Jeffrey S. Hurless
DPM, FACFAS Board Certified Foot & Ankle Surgeon/Podiatrist
Medical Director, HealthyFeetStore.com