Originally published in the Williamson Herald —

Bunions can be uncomfortable to talk about, difficult to manage and painful to live with. Fortunately, thanks to preventative methods and advancements in surgical technology, bunion correction methods have become more effective and, in some cases, less invasive.

“First, it is important to understand what a bunion is,” said Dr. Geoff Watson, orthopaedic surgeon at Bone and Joint Institute of Tennessee. “It’s essentially a crooked toe. A lot of times, it can cause pain from rubbing against the inside of a shoe.”

Although wearing improper footwear—especially high heels and narrow-toed shoes—can increase the risk of developing bunions over time, genetic predisposition also plays a significant role. Many times, laxity in a joint in the midfoot can allow for a bunion to progress and is usually associated with flat feet as well.

So what can you do about bunions? Dr. Watson suggests several proven nonsurgical methods for prevention and correction at home.

Choose Comfortable Shoes

“Make sure you are wearing comfortable shoes such as sneakers that have a wider toe box that does not put pressure on that area,” said Dr. Watson. “We see far fewer complaints of bunions in the summer because people wear sandals and other less restricting shoes that do not cause irritation.”

To help with shoe selection, stores like Fleet Feet and New Balance offer in-store 3D foot scans to highlight problem areas and ensure you choose the proper shoes for your needs.

Try Toe Separators

If you are starting to experience discomfort from bunions, Dr. Watson also recommends using toe separators with shoes. These silicone devices are worn under the socks and train the toe to be straighter, eliminating excess irritation. He also suggests over-the-counter remedies like Voltaren gel and anti-inflammatories for pain relief.

Although bunions are more common in older adults, juvenile bunions are a genetic condition that can develop in patients as young as their teenage years. In these cases, nonsurgical methods are attempted until the patient’s growth plates are closed.

Consider Surgical Options

Bunions can be persistent, painful and even become more severe with time. If you and your physician have concluded that surgical correction is the best option, you can take comfort in the fact that new techniques and advancements in the field have made the procedure easier and more efficient.

After exhausting nonsurgical relief methods, debilitating, long-term pain in the area or throughout the foot would be a reason to consider having surgery, said Dr. Watson.

“The goal of surgery is to reposition the metatarsals on top of the smaller sesamoid bones to straighten the toe and reduce pain,” added Dr. Watson.

In the past, surgeons have corrected bunions using the Lapidus procedure which fuses the bones in the midfoot to straighten them. Following this procedure, patients could not be weight-bearing for as long as six weeks.

However, a relatively new procedure called a Lapiplasty allows for weight bearing in as little as two weeks.

“With a Lapiplasty, we are able to use a guide to make cuts in the bone based on the desired position of the foot,” said Dr. Watson. “We then use two plates with eight screws that lock the position in place and by using this much fixation, we can allow patients to walk on it a lot sooner.”

Also, depending on the stability of the patient’s midfoot, orthopaedic surgeons can also perform an Arthrex minimally invasive bunionectomy.

“In this procedure, we make four small incisions and use a burr to take down some of the bone without harming the ligaments and tendons,” said Dr. Watson. “Then, we use screws to realign the bone.”

In addition to less scarring, this minimally invasive method allows patients to stand on their feet as early as the same day of surgery.

Regardless of the method, all bunion correction procedures are performed on an outpatient basis and typically take less than an hour. After a few weeks in a boot and some self-directed therapy to prevent stiffness, you can gradually resume daily activities though full bone healing typically takes about three months

“With a variety of methods to fit your needs, bunion correction can result in more comfort, less pain and allow for a wider variety of footwear ultimately leading to increased mobility and quality of life,” said Dr. Watson.

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