- Soft, wide, low-heeled leather shoes that lace up
- Athletic shoes with soft toe boxes
- Open shoes or sandals with straps that don't touch the irritated area
A thick doughnut-shaped, moleskin pad can protect the protrusion. In some cases, an orthotic can help redistribute weight and take pressure off the bunion. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may offer some pain relief.
Surgery. If discomfort persists, surgery may be necessary particularly for more serious conditions, such as hallux valgus. There are over 100 surgical variations ranging from removing the bump to realigning the toes.
The most common surgery, an office procedure known as bunionectomy, involves shaving down the bone of the big toe joint. In one procedure the surgeon uses a very small incision, through which the bone-shaving drill is inserted. The physician shaves off the bone, guided by feel or x-ray. It is not a cure, but patient satisfaction is high and results are long-lasting.
 | Click the icon to see an illustrated series detailing bunion removal. |
More extensive surgeries may be required to realign the toe joint. Although there are variations of each, they generally involve one or more of the following:
- Osteotomy (cutting and realigning the joint). Long-term studies on osteotomies report that 90% or more of patients are satisfied with the procedure.
- Exostetectomy (removal of the large bony growth. Only useful when there is no shift in the toe bone itself.)
- Arthrodesis (removal of damaged portion of the joint, followed by implantation of screws, wires, or plates to hold the bones together until they heal.) This is the gold standard for very severe cases or when previous procedures have failed. Good results have been reported in most patients.
- Arthroplasty (removal of damaged portion of the joint with the goal of achieving a flexible scar). This offers symptom relief and faster rehabilitation than arthrodesis, but has risk for deformity and some foot weakness. It tends to be used in older patients. Biologic or synthetic implants for supporting the toes are showing promise as part of this procedure.
- Tendon and Ligament Repair. If tendons and ligaments have become too loose, the surgeon may tighten them.
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