When Do Bunions Require Surgery?

The bump on the side of your big toe might not be a growth but a disfigurement caused by an alignment problem. This is the metatarsophalangeal joint (MTP) at the base of your big toe, and the problem is called a bunion.  

Typically, bunions are a cosmetic issue when they first appear; they don’t usually hurt when they first appear, but they can change the fit of certain shoe styles. Over time, bunions often display symptoms as their misalignment worsens. 

The medical staff at MidJersey Orthopaedics includes several leading podiatrists and foot and ankle surgeons to help you diagnose and treat bunions, whether mild or serious. We’ll recommend the right procedure for your condition, including surgery. 

When do bunions require surgery? Much depends on your individual experience and the severity of your condition. Let’s explore this question further so you know what to expect. 

Is your bunion cosmetic only? 

There’s something obvious about the appearance of a bunion. The end of your big toe points toward the other toes and sometimes pushes them out of position or into each other. 

It doesn’t mean you’ll automatically have symptoms. You won’t need surgery if your bunion condition is only cosmetic. You can keep yourself symptom-free with conservative treatment options, including: 

• Using inserts and pads to reduce friction within your shoes
• Choosing shoe styles with roomy toe boxes
• Customize-designed orthotics that aid the straightening of the affected toe

These approaches can slow the decline of your bunions, and as long as they’re not causing other issues, including pain, you usually won’t need surgery. 

When bunions cause pain

Surgery may be a viable solution when your bunions cause pain, particularly when it interferes with walking. As well as the irritation caused by pressure on the MTP joint, bunions can cause other problems like:

• Bursitis: the inflammation of a cushioning fluid sac in the joint
• Hammertoe: deformities of the middle toes 
• Metatarsalgia: pain and inflammation originating in the ball of your foot

When a bunion begins to create pain and other complications, it’s more likely our doctors will recommend surgery. 

Big toe swelling

Irritation of the MTP joint can cause inflammation that, in turn, leads to arthritis in the big toe. In this case, your bunion may be chronically red or swollen. 

Conservative case starts with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) and cold compresses to reduce Your symptoms. Rest and elevate your feet to aid blood flow and fluid drainage. When home care isn’t enough to provide relief, it’s another hint that surgery may be necessary. 

Joint stiffness

Your normal walking gait requires flexibility of the MTP joint. Without it, your stride changes, potentially causing joint problems in your knees and hips. 

Toe crowding

Deformation of the MTP joint can affect other toes, too, and surgery might be your only alternative to prevent a cascade effect from your bunion. Without treatment, you can expect to develop corns, calluses, and other problems. 

Surgical options

Depending on your bunion condition, you could have several surgical options. We’ll match your foot’s misalignment with the best procedure for you. Bunion surgeries include: 

• Tendon and ligament repair
• Osteotomy, or reshaping of the MTP joint
• Arthrodesis: arthritis treatment removing damaged tissue and rebuilding the MTP joint
• E​​xostectomy: shaving the bone causing the bump, usually combined with other surgical procedures
• Resection arthroplasty: a last resort technique when other bunion surgery fails

Contact the nearest location of MidJersey Orthopaedics by phone or online to schedule your bunion consultation now.