However, when you have severe bunion pain – usually from a bunion that has been in place for a while – it may be time to consider hallux valgus surgery.

feet with bunions

How Do You Know if You Need Bunion Surgery?

Jun 21

Everyone would like to avoid surgery if possible, and if you have bunions (also known as hallux valgus), there are conservative options that can be utilized in the early stages of the development of a bunion to provide pain relief and attempt to delay the need for surgery.

However, when you have severe bunion pain typically from a bunion that has progressed over many years – surgery may be the only means that your physician may suggest in order to achieve pain relief and restore the position of your big toe.

What causes bunions?

Bunions are generally thought to be genetic. They occur because of faulty foot structure, which is inherited. Some conditions that contribute to the development of bunions include flat feet, excessively flexible ligaments, and abnormal bone structure. Some experts believe shoes that don’t fit properly cause bunions, but others think shoes only worsen an existing structural problem. 1

Bunions pain may become worse over time. They can be aggravated by2:

  • tight or too-small shoes that cause your toes to crowd together and put pressure on your big toe
  • shoes that have high heels or pointy toes — these styles force your toes together
  • standing for long periods of time
  • arthritis symptoms in your feet
foot with bunion

Treatment options for bunions

Your physician will be able to provide suggestions on bunion treatment without surgery which can include wearing wide-toed shoes that provide additional space for the impacted toe and limit irritation. Bunion pads, toe spacers, or bunion splints can be inserted in your shoes for greater comfort as well. Your physician may suggest anti-inflammatory drugs such as ibuprofen or aspirin to provide relief, as well as cortisone injections. These nonsurgical treatments can provide relief but typically fail to address the root cause of the bunion.

Bunion surgery addresses the root cause of the bunion and can restore the position of the impacted toe providing relief from pain and swelling in bunions which have progressed. 

Your physician may suggest surgery when you experience significant pain while walking in regular footwear. Another indicator that surgery might be necessary is when you have persistent swelling and inflammation around the big toe that does not improve after rest, or after having used medications.

There are more than 150 possible surgical procedures to address the bunion, and the procedure recommended by your surgeon can be based on the severity of the bunion, your age and health, and quality of bone and soft tissue at the surgical site.3

Traditional bunion surgery may leave a large scar and may require extensive time for recovery.  The minimally invasive Phantom® Nail procedure allows surgeons to achieve correction through a much smaller incision that can result in a smaller scar. Because the nail is contained within the bone following the minimally invasive Phantom® Nail procedure, post-operative irritation in the foot may be reduced. Finally, the minimally invasive nature of the procedure may allow for a more rapid return to activity.

If you want to speak with a surgeon for a consultation about bunion surgery, your next step is to find a qualified foot and ankle surgeon who can help you weigh all the treatment options. For help in finding one in your area, click here to go to the Find a Surgeon page.