When to Consider Bunion Surgery - and When Not

If Simple Treatment Fails, Check Your Reasons for Wanting Bunion Surgery

Elderly woman with bunions on her feet. Credit: Photofusion / Contributor / Getty Images

Question: When Should You Consider Bunion Surgery?

Bunions can cause pain and difficulty, especially when wearing certain shoes. When simple treatments don't relieve your symptoms, surgery may be considered for treatment of the bunion. What are the signs that surgery may be the right treatment for your bunion?

Deciding When Bunion Surgery is the Right Treatment - or Not

Answer: In general, surgery is recommended only when pain from the bunion limits your everyday activities and wearing normal shoes.

There is a common misconception that surgical treatments for a bunion are better and quicker than non-surgical treatments. Unfortunately, patients who rush into surgery may have unrealistic expectations, and may be unsatisfied with surgery.

Three Things to Consider Before Bunion Surgery

Patients considering bunion surgery should understand the following about surgical treatments of bunions. You need to take an honest look at your expectations and your reasons for wanting the surgery.

  • Bunion Surgery Is Not Cosmetic Surgery
    Bunions may not be pretty, but cosmetic deformity is not a good reason to perform surgery. There are too many potential complications to perform a bunion surgery simply for cosmetic reasons.
  • Patients Must Have Realistic Expectations
    Bunion surgery can be helpful in relieving pain, but patients should not expect to have "normal" feet after surgery. In one study, a leading researcher on foot problems such as bunions found that one-third of his patients could not wear the type of shoe they desired prior to surgery. This is a pretty high failure to meet expectations. You have only a two out of three chance, at best, that you'll be able to wear the shoes of your dreams after you've recovered from bunion surgery.
  • The Foot Width Change Is Small
    Bunion surgery decreases the width of the forefoot by about 1/8 of an inch. That's not much! That is the reason why even after surgery, most patients will not be wearing slender shoes. You may have switched to shoes with wide toe boxes because of the bunion, but you will have little chance of tossing them afterward. In fact, if you return to tight-fitting shoes you risk having the bunion return.

    Bottom Line on Why to Get Bunion Surgery

    Surgery can be an excellent treatment option for patients with problems from their bunions. If you have exhausted non-surgical relief and still have bunion pain that is keeping you from enjoying physical activity and is reducing your quality of life, surgery is an option. It is wise to first try different shoes and other corrections. That said, patients must understand this is a procedure that has potential complications and a lengthy rehabilitation.

    People Who Should Reconsider Bunion Surgery

    The patients who tend to be unsatisfied with bunion surgery are those patients who are having surgery done to allow them to have normal looking feet or allow them to wear slim shoes. If that sounds like your motivation, think long and hard about surgery. Surgery should be reserved for those patients who have significant pain, and are unable to correct the problem with adaptive footwear.

    If you aren't already in pain, you could be one of the unlucky people who develops ongoing pain after surgery.

    Trendy shoes are not worth the risks and rehabilitation time.

    Sources:

    Mann, R. "Disorders of the First Metatarsophalangeal Joint" J. Amer Acad Orthop Surg; Vol 3, No 1 1995; p 34-43.

    Steven L. Haddad, "Bunion Surgery," American Association of Orthopaedic Surgeons, February, 2016.

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