A common question that I get asked is, “Should I have surgery on my bunion?” And, the short answer is always, “It depends…” followed by a more thorough exam and work-up including X-rays and a biomechanical evaluation.
The truth is, not every bunion needs surgery. Many patients can be completely comfortable with better shoe choices and possibly orthotic therapy to control the mechanical forces, which are primarily genetic, contributing to the formation of a bunion. I must say that I have a few patients in their 80’s with what I would classify as a “severe” bunion, who have never had any pain. Their shoe choices are limited, but they are not in pain.
If you feel that you have tried some of the non-surgical options such as shoegear changes, orthotics, and limiting or modifying activity, and have not had success, then I think it is reasonable to pursue a surgical solution for more definitive treatment. Certain bunion surgical procedures permit weight-bearing shortly after surgery, and others may require 6 or more weeks of no weight on the foot, necessitating crutches or a walker. It is also critical to evaluate the entire foot, ankle, and leg to determine if there are any other biomechanical issues which are contributing to the formation of the bunion which need to be addressed. The key to a successful result hinges on choosing the proper procedure or procedures, as well as your ability to follow the recommended post-surgical plan.