Bunion surgery is an operation to correct a deformity of the joint at the bottom of your big toe. A bunion (clinical name Hallux Valgus) causes a bony lump to form on the side of your foot which can become painful.
Bunions don’t always initially cause painful symptoms but they can get worse over time, becoming sore or inflamed and they may make it harder for you to find shoes that fit comfortably without pain.
Bunion surgery may be recommended by a Consultant or doctor if your bunion has limited you to wearing specific footwear or you're unable to do the things you want to do without pain.
What are bunions?
Bunions, medically referred to as hallux valgus, are a painful protuberance of bone on the inside of the forefoot. Bunions can cause pain as they "stick out" and rub on footwear. The skin over the bunions thickens and can often become red and sore, especially at the end of the day. The protuberance is the metatarsal bone moving inwards and the toe moving outwards, leaving a bunion where they meet at the big toe joint. This joint becomes crooked and over time the surfaces of bone can become arthritic, adding to the pain of the bunion.
Causes: how does a bunion occur?
There is a common misconception that high heels, or tight shoes can cause bunions - this is not the case. The truth is that bunions are hereditary. Wearing narrow shoes or high heels can only encourage or exacerbate bunion formation in those who are already genetically predisposed. For the vast majority of bunion sufferers, the bunions are inherited and there will probably be family member who has them too.
Unfortunately we can't do anything about your inherited genetics, but we can effectively treat your bunions so you can always put your best feet forwards.
Symptoms: how do you identify a bunion?
In the initial stages, a bunion may be completely pain free, so if your shoes are not rubbing on the prominence of the bunion then there will be no symptoms. However, painful bunion symptoms will be exacerbated for those who wear narrow shoes or high heels, as the bunion may become inflamed, red and uncomfortable. Occasionally, patients may complain that their feet hurt at the end of the day, or when they are wearing tight shoes. Specialist footwear, e.g. work boots or ski boots may become a problem.
When the bunions are more advanced there may be symptoms in-between the toes when they rub against each other. This is mainly between the big toe and the second toe, but sometimes causes problems with neighbouring toes too. As weight-bearing changes, patients tend to weight bear mainly on the second toe metatarsal rather than the big toe, this can result in pain underneath the second or third toes. It is not uncommon for a callus or hard skin to appear in this area and in more advanced cases there may be deformities of the second or third toes, known as hammer toe deformities.
Diagnosis: how do we diagnose bunions?
When you attend your appointment for assessment of bunions, your consultant will examine your foot and ankle, along with your entire lower limb. This will give your surgeon an opportunity to see how your foot is when weight-bearing and while walking. Your consultant will examine the range of motion in the big toe and the degree of flexibility that your metatarsal has and they will also examine the lesser toes to see if there are any deformities or symptoms in those areas.
An X-ray of the affected foot is normally requested in the weight-bearing position to assess the angles of the bones in your feet and the degree of the displacement of the first metatarsal.