Bunions, for those who suffer with them, can be very painful, or may never cause a moment of discomfort. This foot deformity, in which the base of the big toe is prominent on the inner side of the foot and the big toe itself is angled toward the second toe, has been covered by me in a previous post. For an in-depth review on bunions and bunion treatment, see my other article explaining bunions.
The big question on many patient’s minds is when should a bunion be corrected. Fixing a bunion is a fairly straightforward process: it involves a surgery that cuts the bone, moves it back over into a corrected position, secures the bone with a metal screw or pin, and tightens up the supporting tissues. Healing is generally complete in 6-8 weeks in most cases. The question that must be answered is ‘what is the optimal time to do the surgery?’ Unfortunately, there is no simple answer. A number of different factors go into figuring out if a bunion needs correction. The most important factor is whether or not the bunion is even painful at all. If the bunion hurts enough to limit shoe use and activity, then yes, the time is probably right to fix it. If it does not hurt, then surgery may not be necessary. However, depending on one’s age, other factors may need to be considered. For example, if one is middle aged, there is a reasonable expectation that surgery in the future when and if the bunion eventually becomes painful may not be possible due to future health problems. Increasing arthritis in the joint may also force a different kind of surgery that is more involved or has to accomplish a completely different goal like replacing the eroded joint surface. Younger patients may have to consider job restrictions or family life with young children that may make the recovery period difficult, if not impossible. Other factors to consider is the reason behind the desire for fixing the bunion. Bunion surgery will reduce pain and improve the function of the big toe joint and the side of the foot in general. It will not grant the recipient a free pass to wear exceptional high heeled shoes, restrictive fashion shoes, or other such inappropriate footwear without the consequence of pain or discomfort.
Essentially, there is no opportune time a bunion should be fixed due to the complexity of life. A good guideline is that if there is pain enough to affect your life in some way, or if the deformity is visible and bothersome enough that you are anticipating and worried about pain or limitation in the near future, then surgery is right for you. It is a six to eight week inconvenience, but restoration of a more normally functioning foot will reap great future rewards for a lifetime.
Scott R. Kilberg DPM 