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6 Common Questions About Bunion Surgery

If you have a bunion, you may have many questions. In this article, Dr. Sachs discusses 6 common questions he hears from his patients.

1. Why did I develop a bunion?

A bunion, referred to as hallux valgus, is a painful bony bump that develops on the big toe joint of the foot. Typically, bunions progress slowly over time, causing the big toe to gradually lean towards the second toe. The bump and toe deformity will worsen resulting in pain and difficulty wearing shoes or walking.

There are several different causes of bunions. However, many bunions are genetic due to a faulty mechanical structure of the foot, such as flat feet. Bunions can also be caused by medical conditions including osteoarthritis, gout, rheumatoid arthritis, and neuromuscular diseases. In addition, wearing poorly fitting shoes does not cause a bunion, although it can cause the bunion to be more symptomatic and increase the risk of developing a bunion. It’s important to understand the cause of your specific bunion since this may affect the way your surgeon will treat the bunion.

2. When should I have surgery?

Some patients with bunions may ultimately need to consider surgery. Bunions will not go away on their own. A bunion will typically become more painful and worsen with time. Bunions can be treated conservatively (non-surgical) and surgically. However, when the bunion pain starts to interfere with your daily activities, it may be time to discuss your options with a foot surgeon. 

You may also want consider surgery if you have pain and inflammation of the big toe joint, difficulty wearing shoes due to the bunion deformity, develop other pains in your foot, or if you have stiffness of the big toe joint. Your surgeon will take several factors into consideration such as the amount of pain and how long the bunion has been present, your activity level, and your medical history when determining the appropriate surgery for you.

3. Will my bunion come back after surgery?

Although there is always a risk that the bunion may reoccur following surgery, the risk is relatively low.  Bunions can reoccur with even the most successful surgeries. Patients can help to prevent reoccurrence of bunions by following their surgeon’s recommendations. In addition, patients should avoid the habits that may have contributed to the bunion including wearing ill-fitting or high-heeled shoes.  Patients may also wear arch supports or custom orthotics following surgery. 

4. How painful is the surgery?

Many people do experience some degree of pain following surgery, which typically lasts 4-7 days. Bunion surgery is comparable to most other foot and ankle surgeries. With that said, the amount of pain experienced after surgery is different with each person.

Some post-operative pain is expected, which can be controlled with different types of pain medications.  There are a variety of medications that can be used including non-steroidal anti-inflammatories (NSAIDs), acetaminophen, nerve pain medication, and narcotic medication. Your surgeon can prescribe the appropriate pain management regimen for you.

5. When can I walk after surgery?

When a patient can walk after surgery will depend on the type of bunion procedure that was performed.  Some types of bunion surgeries may allow you to walk immediately following the surgery in a protective walking boot. However, depending on the severity of the bunion and complexity of the surgery, you may need to use crutches and not put any weight on the foot for 3-4 weeks. Depending on whether pins, wires, plates, or other implantable constructs were used, restrictions for the amount of weight or pressure you can place on your operated foot may be restricted for additional time.

6. What is the expected recovery time and when can I return to work?

The recovery time following bunion surgery can vary. Initially, the bone takes approximately 6-8 weeks to completely heal. However, in general, it takes approximately 2-3 months to fully recover from bunion surgery. The overall experience of surgery can be an extremely stressful process. Therefore, it’s important that you plan for enough time to allow your body to heal so you have the best chances at a successful long-term result.

Returning to work will depend on the type of work and your physical demands while at work. If your job is relatively sedentary, or if you sit for most of the day, many patients may be able to return to work after 1-2 weeks. However, if your job requires strenuous physical activity, heavy lifting, or long periods of standing, you may be required to stay off from work for a longer period of time. It’s important to understand that if you go back to work too soon, this may result in post-operative complications. In addition, if the surgery is on the right foot or if you drive a manual car, you may not be able to drive for several weeks. Be sure to talk to your surgeon about the risks of surgery and what they expect your recovery to be like based on your specific circumstances.

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