What to expect when having surgery on a bunion

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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From the American Podiatric Medicine Society

A bunion is an enlargement of the joint at the base of the big toe, the metatarsalphalangeal (MTP) joint.

The enlargement is due to a combination of osteoarthritis and bursitis. The net effect is to cause the toe to bend toward the others, leading to a painful lump of bone on the side of the foot. Along the side of the MTP joint, a small sac of fluid (bursa) becomes inflamed and this contributes to the swelling and pain associated with a bunion.

Bunions can cause extreme pain. The MTP joint itself may become stiff and sore, making the wearing of shoes difficult or impossible. Bunions can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor’s bunion."

Treatment options vary with the type and severity of each bunion. Identifying the deformity early is important to avoid surgery. Left untreated, bunions tend to get larger and more painful, making non-surgical treatment less of an option.

The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity.

Several surgical procedures are available for bunions. Surgery is supposed to remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain.

A simple bunionectomy, in which only the bony prominence is removed, may be used for less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint.

Recuperation takes time, sometimes several weeks, and swelling and some discomfort are common following surgery. Pain is managed with medications including anti inflammatory medicines and analgesics.

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