If surgery is necessary we perform it. There are a couple of myths out there about bunions that are not necessarily true. One common myth is that bunions are caused by shoes and that is not always the most significant factor.
Bunions are hereditary and predisposal, meaning that you have the structure and the body/foot function that predisposes the toe to gradually displaces from the major first metatarsophalangeal (MTP) joint, which is one of the major joints in the big toe, and gradually you get this deformity if you don’t correct the function of the foot or at least attempt to control the function of the foot.
If the development of the bunion is not controlled and it becomes painful more than half of the time, more than 50% of the patients pain threshold, then we can consider surgery.
There are many surgical options available. The application of the various surgical options depend upon the severity of the bunion.
- There are mild bunions I can repair the bunion by just manipulating the soft tissue around the first metatarsophalangeal (MTP) joint.
- The next level of surgery which includes manipulation of the soft tissue and shaving the prominence of the joint down.
- The next level generally includes cutting the head of the metatarsal and shifting that head over so the toe is more in line with the metatarsal.
All of these procedures you can basically walk immediately after surgery. And there’s usually a special surgical shoe that you wear for 4-6 weeks after the surgery. After that you’re typically back in regular shoes.
The next level of surgery includes cutting the metatarsal closer to the heel of the foot or closer to the mid foot and shifting the entire metatarsal which requires 6 weeks of non-weight bearing and a boot or a cast as well as the soft tissue manipulation at the joint.
The last level of surgery would include fusing the metatarsal to the midfoot tarsal bones.
How painful is bunion surgery?
It depends on the patients threshold and their experience with surgery. Most of the bunion surgeries are designed so that you can actually place weight on the foot immediately after surgery.
Usually the pain subsides/decreases significantly within the first 3 days. Some patients have very minimal pain and have not used pain medication after the first week and there are some that have required pain medication the first 3-4 weeks. It really just depends upon the person’s pain threshold.
Can you walk after bunion surgery?
Yes, in more than 75% of the bunion surgeries you can walk on the bunion after surgery. Most bunion surgeries are designed so that you can ambulate and walk immediately after surgery in a surgical shoe.
We don’t want people to have to experience pain so we do our best to protect them. I usually give my patients crutches so that if they do have an inordinate amount of pain after surgery, they can at least protect themselves and go at their own pace.
Is bunion surgery really necessary?
It’s necessary if the pain in your foot around your bunion is more than 50% of your pain threshold and it affects your daily life more than 50% of the time or more than 3 days a week, in which case bunion surgery is definitely worth the consideration.
How much does it cost to have bunion surgery?
Usually, for most patients bunion surgery procedures are covered by insurance. If it’s not covered it can cost anywhere between $500 and $2000.