Bunion surgery
Your health expert: Mr Jonathan Larholt, Podiatric Surgeon
Content editor review by Eleanor Bird, February 2022
Next review due February 2025
Bunion surgery is an operation to correct a bunion, which is a deformity of the big toe joint. A bunion is a bony lump on the inside of your foot. This can be painful, especially when you’re walking or wearing shoes. Bunion surgery can remove or straighten the bone to ease your pain.
About bunion surgery
Bunions don’t always cause pain and discomfort. But they can get worse over time. Some bunions progress quicker than others. They may become very sore and make it harder for you to find shoes that fit properly.
Bunion surgery may be recommended by your doctor if nothing else is easing your pain. It’s sometimes also recommended if:
- you can’t buy well-fitting shoes
- you can’t walk properly
- the bunion is significantly affecting your daily life
Bunion surgery won’t be recommended just to make your foot look better.
Preparing for bunion surgery
Your surgeon will explain how to prepare for your operation. If you smoke, you should stop. This is because smoking increases your chances of getting a wound infection and slows down how quickly your bone heals.
Bunion surgery is usually done as a day-case operation. This means you have the operation and can go home on the same day. In certain cases, your surgeon may recommend that you stay in hospital overnight. This might be because:
- you have another medical condition, such as diabetes or high blood pressure
- you’re in a lot of pain after the surgery
You may find it difficult to move around at first after surgery, especially if you’re using crutches. So, it’s a good idea to get your home ready before you go into hospital. You may need to rearrange some furniture and other items so you can reach them easily. If your home has stairs, you may want to sleep downstairs if you have the option to. You will need a friend or family member to stay with you for 24 hours.
You have the choice to have bunion surgery under local or general anaesthesia, but it’s more common to have it under general anaesthesia. This means you’ll be asleep during the operation. A local anaesthetic will be used at the same time to numb your foot and reduce the amount of general anaesthetic that’s needed.
Sometimes, a local anaesthetic can be used on its own to completely block pain in your foot. This means you’ll stay awake during the operation. Your surgeon and anaesthetist will be able to advise on what’s best for your bunion surgery.
If you decide to have a general anaesthetic, you’ll be advised when to stop eating and drinking.
You may need to wear compression stockings to keep your blood flowing and to stop blood clots from forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine (or tablets) as well.
Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you’re happy to give your consent for the operation to go ahead. You’ll be asked to do this by signing a consent form.
What are the alternatives?
If you have a bunion, your GP or podiatrist may recommend several other treatments before opting for surgery. These include:
- taking over-the-counter painkillers such as paracetamol and ibuprofen to ease pain and swelling
- wearing bunion pads to ease pressure on the lump
- wearing insoles or orthotic supports in your shoes
- wearing splints at night to hold your toes straight
- wearing different shoes – for example, low-heeled, wide-fitting shoes that are soft enough to fit around the bunion
Bunions often get worse over time. So, if the above measures aren’t helping and you’re in a lot of pain, your GP may refer you for surgery.
What happens during bunion surgery?
Surgery to remove a bunion usually takes about an hour. But the timing depends on which operation you’re having. There are more than 100 different types of bunion surgery. Your surgeon will discuss which one is best for you. This will depend on many things, including the size of your bunion, what you do for work and socially, and your overall health.
The most common type of bunion surgery is called a metatarsal osteotomy. This involves cutting away the bunion and re-aligning the bones of the joint to make the side of your foot straighter. Your surgeon may make a cut over your big toe joint to remove the bunion. Or they may do keyhole bunion surgery, reaching the bunion through several smaller cuts.
Once the bunion has been removed, your surgeon may use screws or staples to hold everything in place. These are usually left in place permanently but can be removed later if necessary.
If you have bunions on both feet, it’s possible to have surgery to treat these at the same time. But this isn’t usually recommended because you won’t be able to walk on either foot afterwards. Your surgeon will be able to discuss whether or not this may be an option for you.
How bunion removal surgery is carried out
What are bunions | The procedure | Watch in 1 minute 35
A bunion is a lump of bone on the knuckle of your big toe. They can cause pain and discomfort. This video shows one type of bunion removal surgery, and what happens during the operation.
What to expect afterwards
You’ll need to rest until the effects of the anaesthetic have worn off. You may need to take some medicine for pain relief.
Your foot will probably be in a bandage after the operation. Your hospital will usually give you some crutches and a special shoe to wear and will advise you how much (if any) weight you can put on your foot.
A physiotherapist may visit you after your operation to show you how to move around without hurting yourself. They can also teach you how to use crutches and arrange another appointment if you need more help.
You’ll be able to go home when you feel ready and the surgeon considers it safe. This may be about an hour or two after your operation. Your nurse may give you a date for a follow-up appointment before you leave.
Ask a friend or relative to drive you home and to stay with you for 24 hours.
Everyone reacts differently to having a general anaesthetic. If you’ve had one, you may feel particularly tired afterwards. You may also find that you’re not so co-ordinated or it’s difficult to think clearly. This should pass within around 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or sign any important documents.
Recovering from bunion surgery
After your operation, you’ll be given pain killers. Always read the patient information leaflet that comes with your medicines. If you have any questions, ask your pharmacist for advice. Mild pain is common in the first 24 to 48 hours, then it will improve. If you continue to have pain after finishing your course of painkillers, contact your surgeon.
Keep your dressing dry. If you can, ask someone to help you to balance while you shower or bathe so you can keep it dry. Alternatively, you may find it easier to have a wash-down instead.
Your surgeon will give you advice that’s specific to you because it will depend on which operation you’ve had. You’ll probably be able to put weight on your other foot (the one that didn’t have the surgery) straight away. It’s important to rest with your foot up for the first couple of weeks because this will help to reduce any swelling.
You’ll usually have dressings and a bandage on your foot after bunion surgery. In some cases, you may need to wear a surgical (post-operative) shoe, a cast or a boot. Your surgeon will advise how long to wear it for. If you have a boot or cast, it’s likely that this will be on for longer than a post-operative shoe. After around two weeks, your stitches will be removed and a splint put in place to hold your toe steady for a further four weeks.
After your surgery, it’s important to start moving your toe to keep it flexible. Your surgeon or physiotherapist will explain how to do this safely.
It usually takes three to six months to get back to normal walking or sports activities after bunion surgery. But everyone recovers differently. The main thing is to not do too much, too soon.
You can usually drive again once you’re able to do an emergency stop safely. But check with your surgeon and car insurance company first. You’ll also need to wait until you’re able to wear normal shoes again – this may take six to eight weeks.
How quickly you can return to work will depend on your job. If your job involves sitting down most of the time, you can probably go back to work six weeks after bunion surgery. But if your job involves a lot of standing, walking, carrying or lifting, you may need to be off work for up to 12 weeks.
Whether or not you drive to work will also affect when you can return to work. Your surgeon or specialist nurse will be able to advise you on this.
Side-effects of bunion surgery
Side-effects are unwanted but mostly temporary effects that you might get after having the operation. Side-effects after bunion surgery may include:
- a sore foot, especially your big toe
- swelling of your foot
It may take six months to a year for your swelling to go down completely.
Complications of bunion surgery
Bunion surgery can cause some complications. These include:
- a stiff toe – this doesn’t bother most people, but it can be important for athletes or dancers
- a numb toe – the nerves in your toe may be injured
- an abnormal toe position – your big toe may heal out of line and bend outwards or upwards; it may be slightly shorter
- an infection – for which you may need antibiotics
- pain under the ball of your foot – this can happen if there’s a change in the distribution of your weight
- the bunion coming back – or a corrected bunion may get worse so you may need to have another operation
When to see or contact your doctor
Contact your hospital or GP if you have:
- a high temperature
- worsening pain or pain that doesn't get better when you take painkillers
- redness around your dressing or if it feels warm
- swelling or pain in your calf muscle of your leg
- any discharge from your wound
Looking for physiotherapy?
You can access a range of treatments on a pay as you go basis, including physiotherapy.
To book or to make an enquiry, call us on 0370 218 6528∧
If you decide not to have surgery, your bunion may get bigger and hurt more. Very bad bunions can develop osteoarthritis of the big toe joint and may increase your chances of falling over. However, not everybody needs surgery for a bunion and your GP or podiatrist may suggest treatments that don’t involve surgery.
For more information, see our section: What are the alternatives?
You may be able to wear high-heeled shoes occasionally if your foot recovers well after bunion surgery. But you’ll need to wear more comfortable shoes such as trainers and flat boots, for the first few months. Your podiatrist can give you advice about good foot care and how to prevent getting a bunion in the future.
Recovery time depends on the type of bunion surgery you’ve had. It’s likely that for the first two weeks you will need to rest and elevate the affected foot as much as possible. After this you can start to walk more by putting your weight on your heel. You may be given a special shoe and crutches to help you walk in the six weeks after surgery.
For more information, see our section: Recovering from bunion surgery.
General anaesthesia
General anaesthesia is when medicines are used to send you to sleep and stop you feeling pain and other sensations
Local anaesthesia
Local anaesthesia involves numbing a small part of your body with a medicine called a local anaesthetic
Over-the-counter painkillers
Bunions
A bunion is a painful lump that can develop on the side of your foot and affect how you walk.
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