Foot & Ankle Surgery, Orthopedic Surgery

April 18, 2022

When is the Right Time for a Bunionectomy?

Illustration of the anatomy of a foot

Bunions are a common deformity of the foot that can lead to pain, inflammation, and problems with walking if they are not treated. Not every bunion needs surgery to correct the problem, but if you have severe pain or trouble moving comfortably, a bunionectomy may be the answer. It is a complicated surgery with a relatively long recovery period, so it’s essential to consider all your options before moving forward with a bunionectomy.

What is a Bunion?

A bunion is a malformation of the foot that occurs when the big toe is misaligned. The bones at the base of the toe move out of place, with the joint turning in toward the foot. The metatarsal joint at the big toe’s base is shoved out when this happens. The result is a knot sticking out of the inside of the foot and the big toe pushing inward toward the other toes.

Bunions can be caused by injuries or shoes that don’t fit properly. Rheumatoid arthritis in the feet often leads to bunions. There is also a genetic component, as bunions often run in families. If you wear high heels or shoes with a narrow toe box, it can aggravate a bunion, leading to pain, inflammation, and redness. If left untreated, bunions can dead to pinched nerves in the feet, hammertoes, and debilitating pain.

What Are Some Non-Invasive Bunion Treatments?

Bunions aren’t painful in their early stages, but they can worsen over time if you don’t treat them properly. Wearing shoes with a wide toe box and low heels may help reduce discomfort and give your toe freedom of movement. Icing the toe joint and using over-the-counter medications or anti-inflammatories may also help if you only have occasional discomfort.

If this doesn’t help, consider padded orthotics inserted in your shoes. These should feature good arch support, a ridge supporting the ball of the foot, or both to take pressure off the toes and distribute weight more evenly on your feet. In some cases, a splint may be used to reposition the toe and gently ease the joint back into place over several months.

If the pain is daily or becomes severe, you may need to consider a bunionectomy to prevent further damage to the foot bones and restore a normal walking gait.

When is it Time to Consider a Bunionectomy?

If orthotics and adequately-fitting shoes don’t relieve your pain, it may be time to consider bunion surgery. A few signs that you need to consider this orthopedic foot surgery include:

  • A painful, inflamed bunion
  • Difficulty finding shoes that fit over your bunion
  • Limping or favoring one foot, causing an abnormal gait
  • Your big toe being pushed so far in that it overlaps your second toe
  • Tingling or numbness in the ball of your foot or your toes
  • Pain in the ball of your foot
  • Thick calluses on and around the bunion
  • Hammertoes
  • Bone spurs in the foot
  • Failure of non-invasive bunion treatments

The ideal time for a bunionectomy is when other options for treating the bunion have failed, but before the pain and inflammation have become debilitating. The surgeons at Arkansas Surgical Hospital can evaluate your feet and determine whether a bunionectomy is right for you.

What Happens During a Bunionectomy?

A bunionectomy involves removing a portion of the enlarged joint’s bone and realigning the ligaments, tendons, and muscles surrounding the joint. Bunionectomies are minimally invasive except in the most severe cases. A small incision is made on the top or interior side of the foot for the surgery.

If the bunion is severe or the joint is arthritic, the bone may have to be fused or screws may be needed to hold the joint in place after realignment. Over time, the bones will fuse together to alleviate pain and prevent the toe joint from moving.

If bone spurs have developed in the area around the big toe, part of the bone may be removed to shorten the joint. After the toe is repositioned, screws are used to keep the bone in place. Then, the ligaments and tendons surrounding the metatarsal bone are surgically lengthened or shortened to accommodate the new alignment.

How Long Does it Take to Recover from a Bunionectomy?

After your bunionectomy, you’ll recover at home, elevating your foot for the first few days. Pain medication and ice will keep swelling and pain under control. For the first few weeks after surgery, you’ll wear a dressing over the incision and boot or splint.

Exercises to strengthen the foot and ensure proper movement are crucial following bunion surgery. Depending on the severity of the surgery, you may start exercising immediately or have to postpone it for a few weeks. Your surgeon and physical therapist will advise you on how to prevent stiffness in the toe joint and promote flexibility in the ball of the foot so that you can resume a comfortable gait.

Most patients can return to full use of the foot, including driving, within two months. Complete recovery takes between two and six months, but you should avoid wearing high heels or constrictive footwear for at least six months. If you have a sedentary job and can occasionally elevate your foot, you may be able to return to work after six weeks. If your job requires long hours on your feet or lots of working, however, you may have to wait up to three months before returning to work. Most patients can return to sports within six months.

Is it Time for a Bunionectomy?

The surgeons at Arkansas Surgical Hospital have performed many bunionectomies to relieve the pain, swelling, and deformity caused by bunions. Request an appointment today to discuss the severity of your bunions and how they’re impacting your life. Our podiatric surgeons can help you determine whether it’s time to consider a bunionectomy.

Photo by Anne Nygård on Unsplash

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