Bunions develop as the result of poor balance and forces put on the front of the foot as well as shoes that are too tight and narrow to accommodate the toes. Surgery is the only real "cure" for bunions, but this is not a guarantee that the bunions will not come back. If you continue wearing high heels that are too narrow, you could develop another bunion.
Bunion Definition
A bunion is a bony bump that forms on the joint right at the base of the big toe. As this bump enlarges, it forces the alignment of the big toe to go out, which, in turn, forces the alignment of the second and third toes to go out. In time, the poor alignment of your toe can become painful. Some causes of bunions include an imbalance in the forces exerted on your foot joint as you walk and poorly fitted shoes. These include shoes with a heel more than two inches high and shoes with pointed toes.
Symptoms
Bunion symptoms include a bump on the outside of the big toe, thickening of the skin at the base of the toe, swelling, redness and soreness around the joint of the toe, pain that is persistent or intermittent, restricted movement of the big toe, and corns/calluses developing where the first and second toes begin to overlap. The smaller toes can be affected by the pressure of your big toe, which might cause your toenails to begin growing abnormally. Your smaller toes could also develop a claw-like appearance (hammertoes).
Expectation of Surgery
Your surgeon will perform surgery (bunionectomy) in order to relieve pain from the misalignment of your big toe. He will also remove excess bone growth; he may also remove some soft tissue and realign the ligaments in order to straighten your big toe with no guarantee that you will be completely pain-free after surgery. If your deformity is severe, your surgeon may need to combine surgical procedures. A bunionectomy usually takes approximately one hour; depending on the type of surgery you may need, it could take longer. You will be given a regional anesthetic that will only affect your foot and you may be sedated during surgery.
Types of Surgery
The surgery you may need will depend on your specific foot deformity. Your surgeon may decide to remove a part of the bone that is bulging out. He may have to realign the soft tissues or ligaments around your big toe joint if they have been forced out of proper alignment by the growth of your bunion. You may have a small wedge of bone removed from your toe. You may have some bone removed from the end of the first metatarsal (the bone that connects to your big toe). At this joint, your metatarsal bones and big toe are going to be reshaped. Your surgeon may fuse the big toe joint. He may also fuse the joint where the metatarsal bone joins with your mid-foot. You may wind up having an implant of all or part of an artificial joint inserted into your foot if the damage to your foot is severe enough.
Post-Surgical Recovery
Your recovery period will range from six weeks all the way up to eight months, depending on the degree of surgery you underwent. You may need one year to fully recover. You can take acetaminophen or ibuprofen for pain management unless your doctor prescribes a prescription pain killer. After you go home, you have to keep weight off of your foot for a period of six to eight weeks and keep your foot elevated higher than your heart for several days. You may be given a special shoe or boot once you reach this stage of recovery. While you still have stitches in your foot, you have to keep the stitches dry when you bathe or shower. Your stitches will be removed in one to three weeks. If your surgeon inserted pins during surgery, these will be removed in three to four weeks. Your doctor may allow you to return to some of your normal activities in approximately six to eight weeks.
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