Bunions - surgery is not the only option
Many patients with bunions can manage their symptoms without the need for surgical correction. There are a number of modalities that can be helpful. Changing your footwear is key. Basically wearing shoes that are wide around the toes and have a low heel can help alleviate the symptoms. Physiotherapy and strengthening of the small muscles within the foot can help with symptoms of foot pain in general and there are certain exercises that may be helpful. Toe spacers can help, if there is any friction between the toes or to help with controlling a hammer toe deformity if this is rubbing in footwear. These splints or spacers are not likely to resolve any defomrity and are only there to relieve friction smptoms.
If the non-surgical methods described above fail and you have ongoing symptoms or, if there are problems arising in the second or third toes because of the bunion, then one could consider surgery to correct the bunion.
The aim of surgery is to realign the first metatarsal so that it is no longer pointing towards the inside of the foot. This is done through an incision on the inner aspect of your foot and the first metatarsal bone is cut and then realigned and fixed with screws (Scarf or Chevron osteotomy). At the same time, a correction of the actual big toe bone may also be required to realign it so that it is more straight (Akin osteotomy). This will also need to be fixed with a staple or a screw.
Whilst there are hundreds of operations described to correct a bunion. The combination of a Scarf and Akin osteotomy is now considered the gold standard and the vast majority of UK surgeons choose this surgery for the correction of bunion deformity with very high success rates.
On occasions, if there is a lot of arthritis within the big toe joint, as well as a bunion, then you may be recommended to have a big toe fusion surgery to straighten the bunion, but also to get rid of the arthritis pain. Very rarely, if the deformity is severe, you may be required to have a fusion operation in the mid foot, known as a lapidus fusion but your surgeon will discuss your particular case with you.