Bunion surgery: reasons, techniques, risks and recovery

A bunion is a bony bump at the base of the big toe, usually with the toe angled towards the others. Many people live with one without trouble. The aim of surgery is to relieve pain and rubbing that persist, not to make the foot look neater.

The NHS suggests starting with wide, low-heeled, soft-soled shoes, bunion pads, paracetamol or ibuprofen, weight loss if relevant and possibly orthotics, toe spacers or splints. Milton Keynes says surgery is recommended only when those measures have been exhausted and the symptoms remain significant.

People with diabetes should seek advice earlier, because the NHS flags that foot problems are more serious for them.

The alternatives are measures, not a cure: the bump will not shrink with pads or splints, but pain may be manageable. If shoes are the main trigger, changing footwear can be a realistic choice.

• A podiatrist can review footwear, pressure points and corns, and suggest insoles or toe spacers.

• Ice wrapped in a tea towel for up to 5 minutes can ease soreness, according to the NHS.

• Painkillers help temporarily. Ask your GP about safe options if you take other medicines.

• Watchful waiting is reasonable if pain is occasional and not affecting walking.

At pre-assessment the team will check your general health and explain fasting and which medicines to take. Smoking matters here: Milton Keynes links non-union, where the cut bone does not knit, to smoking, so stopping before surgery is worth discussing seriously.

Practical preparation includes sorting out how you will manage stairs and the bathroom with a protected foot, a footstool to keep the foot raised, and someone to drive you home. Bring loose trousers and a shoe or sock for the other foot.

Milton Keynes describes a general anaesthetic as the usual choice, with spinal or regional anaesthesia that numbs the leg as alternatives to raise with your anaesthetist. A cut is made on the inner side of the foot.

The bump is removed, and the long bone behind the big toe, the first metatarsal, is cut and repositioned so the toe lines up, then held with screws. Extra cuts may be needed and may be held with screws or staples. The foot is dressed and a surgical sandal fitted. The NHS says most people go home the same day.

The NHS says toes may be weaker or stiffer, not perfectly straight, the foot may stay painful, and bunions sometimes come back. Milton Keynes adds swelling that can take more than six months to settle, bone that fails to join, changes in toe position, pain under the second toe, nerve injury, infection, blood clots and complex regional pain syndrome.

None of the pages retrieved gave percentages, so none are quoted. Ask your surgeon how often problems like recurrence or stiffness arise in their own practice.

Milton Keynes says you can put weight through the foot straight away in the sandal, with the leg raised as much as possible. Clinic visits are at 2 weeks for stitch removal and a splint, and at 6 weeks with an X-ray to confirm healing.

The NHS suggests resting with feet raised for at least 2 weeks and avoiding driving for 6 to 8 weeks, whereas Milton Keynes says you may drive when comfortably walking in your own footwear and able to stop in an emergency. The recovery timeline page sets out these stages and explains why the figures differ.

Contact the hospital or your GP promptly for increasing redness, discharge, fever, or pain that is climbing rather than easing. A hot, swollen, tender calf or sudden shortness of breath needs urgent help; call 999 for breathlessness or chest pain. A toe that turns white, blue or cold needs same-day assessment.

• Which technique will you use for my type of bunion?

• Will you use screws, and are they ever removed?

• How long will I be unable to drive and work?

• What is the chance the bunion returns?

• Who will provide physiotherapy or footwear advice afterwards?

Some NHS areas restrict bunion surgery to people with significant pain or difficulty walking rather than appearance, which fits the leaflet wording. Private care may offer more choice of technique and quicker dates, but the same recovery rules apply. Ask whether follow-up X-rays and physiotherapy are included and what happens if revision is needed.