Bunions: symptoms, treatment, surgery and recovery

The NHS says you cannot get rid of bunions or stop them getting worse yourself, but there are things you can do to ease any pain. If you see a GP, they will look at your foot and ask about your symptoms, and may refer you to a foot specialist (podiatrist). A GP or podiatrist can advise on things you can buy or have specially made to reduce bunion pain, such as insoles (orthotics), toe spacers and toe supports (splints). You can also pay to see a foot specialist privately.

Milton Keynes University Hospital describes an operation as only recommended as a last resort, once all non-operative treatment measures have been exhausted, and if symptoms remain significant.

The NHS says the main symptoms of bunions are hard lumps on the sides of your feet, by your big toes. Your big toe may point towards your other toes. You may have hard or swollen skin, and the bunion may look red or darker than the skin around it. You may also have pain along the side or bottom of your feet, which is usually worse when wearing shoes and walking.

If you are not sure it is a bunion, the NHS lists other possible causes of foot symptoms.

A bunion is a bony lump at the base of the big toe where the big toe has drifted towards the other toes. The NHS says the cause of bunions is not always known, but you may be more likely to get them if you wear shoes that do not fit properly. Milton Keynes University Hospital says they tend to run in families and are more frequent in women.

The NHS lists the following self-care steps. You may be able to refer yourself directly to a podiatrist without seeing a GP: ask the reception staff at your GP surgery, check your surgery's website, or contact your integrated care board to find out if there are services in your area.

• Wear wide shoes with a low heel and soft sole.

• Hold an ice pack (or a bag of frozen peas) wrapped in a tea towel to the bunion for up to 5 minutes at a time.

• Try bunion pads from a pharmacy.

• Take paracetamol or ibuprofen.

• Try to lose weight if you are overweight.

• Do not wear high heels or tight, pointy shoes.

• Make sure your shoes are the correct size and have enough room for your toes.

A GP may refer you for surgery if your bunions are very painful or they are having a big effect on your life. The NHS says surgery is not done just to improve how your feet look. The most common operation is an osteotomy, which involves making a small cut or cuts in the skin over the big toe, cutting or scraping away the bunion, straightening the toe bone and fixing it in place with metal screws or staples, which are often left in permanently.

Surgery is usually done under general anaesthetic, but sometimes under local anaesthetic. Most people go home the same day. Milton Keynes University Hospital says the operation may be done under general anaesthetic or with a spinal or regional anaesthetic, with the big toe repositioned and held with screws to allow the bone to heal.

The NHS says it can take a while to recover from bunion surgery, and lists what you will usually need to do. Milton Keynes University Hospital describes wearing a surgical sandal continuously for six weeks, being seen at two weeks and again at six weeks with an X-ray, returning to desk-based work about two weeks after surgery if you can elevate your foot, and avoiding high-impact exercise for 12 weeks.

After the operation, the NHS says your toes might be weaker or stiffer than before, your toes may not be perfectly straight, and your feet may still be painful. Bunions sometimes come back after surgery.

Milton Keynes University Hospital lists swelling that takes more than six months to settle, stiffness of the big toe, non-union (the cut bones not healing, at much higher risk in people who smoke), the toe tilting back to its original position or the other way, pain under the second toe, prominent metalwork, nerve injury causing numbness, infection, blood clots and chronic regional pain syndrome. Talk to your surgeon about the risks and benefits for you.

The NHS says to see a GP if pain from a bunion has not improved after trying home treatments for a few weeks, the pain is stopping you doing your normal activities, your bunions are getting worse, or you have bunions and diabetes, because foot problems can be more serious if you have diabetes.

On the NHS, bunions are managed with self-care and podiatry, with referral to an orthopaedic or foot and ankle service for surgery if symptoms are severe. Some areas allow self-referral to podiatry. Some people pay to see a podiatrist or surgeon privately for quicker assessment or surgery. Whichever route, a surgeon should explain the likely benefit, the risks and the recovery period for your operation.