Bunion surgery

Expert reviewer, Mr Roger M Tillman, Consultant Orthopaedic surgeon
Next review due January 2023

Bunion surgery is an operation to correct a bunion, which is a deformity of the joint at the bottom of your big toe. A bunion causes a bony lump to form on the side 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.

Image showing a bunion in the right foot

About bunion surgery

Bunions don’t always cause symptoms. But they can get worse over time. They may become very sore and may 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 or walk properly or if the bunion is significantly affecting your daily life. But bunion surgery won’t be recommended just to make your foot look better.

Preparing for bunion surgery

Your surgeon will explain how to get ready for your operation. If you smoke, you may be recommended to stop. This is because smoking increases your chances of getting a wound infection, which can slow down your recovery after surgery.

Bunion surgery is usually done as a day-case operation. This means you have the operation and can go home on the same day.

It’s a good idea to get your home ready before you go into hospital. You may find it difficult to move around at first after surgery, especially if you’re using crutches. You may need to rearrange some furniture and other items so you can reach them easily. You may need some extra help too, so see if your family or friends can stay with you.

You’ll usually have bunion surgery under local anaesthesia. This will completely block the pain in your foot, and you’ll stay awake during the operation. Your surgeon may give you a sedative with the local anaesthetic to help you relax. If a local anaesthetic isn’t right for you, you may be able to have general anaesthesia instead – this means you’ll be asleep during the operation.

A general anaesthetic can make you sick so it’s important that you don’t eat or drink anything before surgery. Follow your anaesthetist’s or surgeon’s advice.

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, podiatrist or chiropodist may recommend several other treatments before you have surgery. These include:

  • taking medicines 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 (or stretching your shoes to fit 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 less than an hour. But the timing depends on which operation you’re having. There are lots of different types of operation to treat bunions. Your surgeon will discuss which one is best for you. This will depend on many things, including the size of your bunion and your overall health.

The most common type of bunion surgery is metatarsal osteotomy. This usually involves removing some bone and re-aligning the joint to make the side of your foot look straighter. Your surgeon will make a cut over your big toe joint to remove the bunion. Or they may do keyhole surgery, reaching the bunion through several smaller cuts.

Once the bone has been removed, your surgeon may use screws or wires to hold everything in place. This is usually permanent, but sometimes your surgeon will remove the screws or wires later. If you have bunions on both feet, it is possible to have surgery to treat these at the same time. But this isn’t usually recommended, as 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.

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 usually be in a bandage after the operation and you may have a cast. 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 usually be able to go home when you feel ready. 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.

If you’ve had a general anaesthetic, ask a friend or relative to take you home. Also ask them to stay with you for a day or so while the anaesthetic wears off.

Everyone reacts differently to having a general anaesthetic. If you’ve had one, you may feel tired afterwards or even exhausted. 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.

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Recovering from bunion surgery

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine, and if you have any questions, ask your pharmacist for advice.

Keep your dressing and cast dry. Put a plastic bag over your foot when you have a shower. If you can, ask someone to help you to balance as you keep it dry. Or you may find it easier to have a wash-down instead.

Your surgeon will give you advice that’s specific to you, as 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. But it’s important to rest with your feet up on a stool in the first few weeks because this will help to reduce any swelling.

You may need to wear a cast for four to eight weeks. Then, after around eight weeks, you may be given a removable boot or walking cast so you can start putting weight on your affected foot. You’ll usually need to use crutches to help you get around.

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 around 10 weeks.

How quickly you can return to work will depend on your job. Most people take six to eight weeks off work 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.

Side-effects of bunion surgery

Side-effects are the unwanted but mostly temporary effects 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
  • weakness of your leg if you’re wearing a cast for several weeks

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, or 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/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

Frequently asked questions

  • Your doctor will usually recommend surgery if your bunion is very painful and stops you walking properly. If you decide not to have surgery, your bunion may get bigger and hurt even more. This can affect your posture and balance. Very bad bunions can cause osteoarthritis of the big toe joint and may increase your chances of falling over.

    Your GP, podiatrist or chiropodist may suggest treatments that don’t involve surgery. These include things like pads to ease the pressure on your bunion, insoles and wearing splints at night. These may help with the pain but they won’t stop your bunion from getting worse over time. So, you may still need to have surgery eventually.

  • You may be able to wear high-heeled shoes occasionally if your foot recovers well after bunion surgery. But you’ll need to wear comfortable shoes, such as trainers and flat boots, for the first few months. If wearing high-heeled shoes is uncomfortable after bunion surgery, you should switch to lower-heeled shoes.

    If you wear tight or ill-fitting shoes, they may increase your chances of getting a bunion again in the future. Your chiropodist or podiatrist can give you advice about good foot care. Wider, deeper shoes are better for your feet, as are shoes with an adjustable strap or lace. Choose shoes with a heel that’s no higher than 4 cm to wear every day. Your chiropodist or podiatrist may suggest you wear insoles inside your shoes too.

    Doctors don’t recommend bunion surgery for purely cosmetic reasons. So, you won’t be offered surgery just to make your feet look good or so that you can wear high heels again.

  • With some types of bunion surgery, you may be able to walk on your foot within a few days. But it’s important to speak to your surgeon to see how well you’re recovering.

    With other types of bunion surgery, you’ll probably be able to put weight on the foot that didn’t have surgery straight away. But you’ll still need to keep your weight off the affected foot for a while and use crutches to get around. You may be able to walk on both feet again after around eight weeks. Or you may need to wear a walking cast or removable boot for a while.

    It may take three to four months until you can walk well enough to get back to your usual activities and play sport. But remember that recovery times are different for everyone. There’s no right or wrong – don’t rush to do too much before you’re ready, and always check with your surgeon first.

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  • Reviewed by Victoria Goldman, Freelance Editor and Michelle Harrison, Specialist Health Editor, Bupa Health Content Team, January 2020
    Expert reviewer, Mr Roger M Tillman, Consultant Orthopaedic Surgeon
    Next review due January 2023