By Dr. James Marks

Not a day goes by that a patient tells me that they wake up most days hoping that today will be the day when their bunion, or big toe joint, will not hurt. By the time they come into the office, they have tried changing shoes, using orthotic devices or pads/splints, or taking over-the-counter medication. Unfortunately, these options don’t always work for everyone.

So, what is a bunion, and what are the symptoms?

A bunion, known as “Hallux Valgus,” is a localized area of enlargement or prominent “bump” of the inner portion of the joint at the base of the big toe. The enlargement represents a misalignment of the big toe joint that causes the big toe to turn inward toward the other toes, thus pushing against the other toes, sometimes diving over or under them. This can result in damage to the toes, causing foot and joint pain, hammertoes, corns and calluses. If left untreated, painful bunions may eventually cause difficulty in walking as well as the inability to wear certain shoes, impacting work and leisure activities. However, some people with bunions never develop symptoms. Shoes that crowd the toes can increase the risk of symptoms, but they do not cause bunions directly.

So, how do you know when you need bunion surgery?

In general, surgery for bunions is most often recommended when the pain from the bunion prevents a patient from wearing regular shoes and performing their normal daily activities. Surgery is not indicated if you think the bunion is ugly and it is keeping you from wearing attractive shoes. You should consider the following three criteria if you elect to proceed with bunion surgery:

Pain is present, and it is limiting your ability to do the things you like, love or must do.

You have tried and failed some of the above conservative options.

You have realistic expectations about your bunion surgery results

Most patients who undergo bunion surgery experience a dramatic reduction of foot pain after surgery, along with a significant improvement in the alignment of their big toe. In fact, a survey by the American College of Foot and Ankle Surgeons found that 90 percent of patients reported significant pain relief and increased physical activity, 6 to 24 months following bunion surgery. Ninety percent also said they would recommend the surgery to others. However, patients who rush into surgery may have unrealistic expectations and may be unsatisfied with their results.

Bunion surgery, just like any surgery, can have complications. The length, the kind of, and the severity of any complication will differ depending on the person, their age, their physical health, and the kind of bunion surgery performed. Because bunion surgery is usually an elective procedure, take the time to discuss your questions and alternatives with one of our foot and ankle surgeons. Patients who are having bunion surgery for the right reasons end up with a good to excellent outcome and would tell you that bunion surgery is worth it.

If you are suffering from bunions or know of anyone who is presently suffering from bunion pain, talk with your primary care physician about a referral to Washington Health Systems/Foot & Ankle Specialists or schedule an appointment at one of our convenient locations, Waynesburg Washington or Cecil, by calling 724-222-5635 or go to whs.org/footandankle.

New patients are always welcome.

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