A Bunion story. Before and after | Florida Podiatrist #toppodiatrist

Let's dive into the topic of bunions. I often get asked, "What exactly are bunions?" Many people notice a small bump on the side of their foot and wonder what it means. To put it simply, a bunion is not just a calcium deposit as some might think. Instead, it's a deviation of the bones in your foot. When you look at a normal foot, the angle between the first and second toe should be under 8 degrees, meaning the bones are almost parallel. However, in the case of a bunion, these bones deviate, causing the joint to angle outward. This results in the bump you see on the side of the foot.

Bunions often form due to inherited foot types. For example, if flat feet run in your family, you may be more prone to developing bunions. As the foot flattens, the first metatarsal fans out, leading to severe bunions where the big toe may overlap or underlap the second toe. There's some debate about when to treat bunions. Some doctors believe that if a bunion isn’t causing pain, it’s best left alone. However, waiting too long can lead to significant pain and arthritis later in life. I’ve had patients in their 70s and 80s who were told to wait, only to develop painful, arthritic joints that could have been treated earlier.

If your bunion bothers you, especially in shoes or daily activities, it's time to see a podiatrist. Advances in surgery, like minimally invasive bunionectomies, allow us to correct the deformity with minimal incisions, reducing the risk of complications. For example, I perform a scarless bunionectomy using a small incision and traditional tools like a chisel and hammer to avoid damaging the bone. This procedure realigns the toe, and patients can walk out of surgery in a boot, usually wearing it for six to eight weeks.

For those interested, you can find more details and see the results of these procedures on my website, ScarlessBunion.com. The proof, as they say, is in the pictures. If you’re considering a bunionectomy, whether traditional or minimally invasive, it's crucial to weigh the benefits and risks. With modern techniques, we can often minimize complications and help you return to your regular activities with minimal downtime.

Bunion Surgery

What is a bunion? 

A bunion is a bony protrusion located at the base of the big toe. This is actually not a new bone growth, but rather just the bone that is slowly being pushed outwards due to weak structures in the foot or abnormal foot mechanics.

How do you treat bunions?

The only treatment for bunions is through surgery. Bunion surgery usually involves realigning the first metatarsal so that the joint no longer deviates. This is done by applying local anesthetic to numb the affected foot. In some cases, a sedative may be used to calm the patient. The surgery usually lasts an hour or so and is commonly done on an outpatient basis. The aim of bunion surgery is to restore the normal alignment of the joints and eliminate pain. 

What are the major types of bunion surgery? Types of bunion surgery

1. Traditional Bunion Surgery

Traditional or Typical bunion surgery is done by making an incision, around 5 to 7 cm, to expose the bulging bone. Then a part of the metatarsal head is removed. This process is called bunionectomy or exostetomy. The bones are then positioned and pinned in place and excess bone is removed. In this type of bunion surgery, expect swelling and pain after surgery. It takes about 6 to 8 weeks for recovery to occur, during which time, crutches are required when moving around.

Minimally Invasive Bunion Surgery

This is a new bunion surgery technique, also called no scar bunion surgery or scarless bunionectomy, is less invasive compared to the traditional type of surgery. This involves a very small incision, around 5mm or less. Then a live x-ray is used to help the surgeon locate the best place to cut the metatarsal bone. After cutting, the bone is repositioned to its adjacent metatarsal bones to get the foot as normal as possible. Once the bone is realigned to its ideal location, a pin is inserted to immobilize the bone and the incision is closed. Minimally invasive bunion surgery is virtually painless and the procedure is done as an outpatient basis. There is very little to no pain after surgery, and recovery time is only about 2 to 3 days.

Home Treatments for Bunions

A bunion is characterized by a painful and swollen bump in the joint connecting your big toe to your foot. The enlargement that is seen is actually a misalignment of the big toe joint.


There are many causes for bunion formation. One of the causes is having abnormal foot biomechanics like overpronation. Other causes are previous foot conditions such as sprains, fractures, nerve injuries, loose ligaments, and low muscle tone.

Heredity also plays a role in bunion formation. The risk of having bunions is increased if other members of the family have the condition. Gout and rheumatoid arthritis is also said to be associated with bunions.

Using ill-fitting shoes is likely to make an existing bunion worse. Wearing high heels also cause considerable strain on the toe joint because they tend to push the body weight onto the front of the foot.

Here are home treatments for bunions that can ease the pain and discomfort:

1. Take nonprescription medicines such as ibuprofen or acetaminophen following the recommended dose to help relieve toe pain. 
2. Elevate the foot to help reduce inflammation. 
3. Apply ice to the painful joint  to ease pain.
4. Use orthotics, arch supports, or bunion pads at the bottom of the foot to redistribute the weight and take the pressure off the big toe.
5. If possible, use custom made shoes to ensure proper fit. Another way is to use shoes with a bigger toe box. There should be enough space between the tip of the longest toe to the end of the shoe. The shoes should not squeeze any part of the foot and should be roomy enough for the toes. Switching to sandals instead of closed shoes can leave the painful area of the foot exposed.
6. Pads inside the shoes or foam rubber cut into a doughnut shape with the hole for the bunion is another easy but effective home remedy.
7. Avoid activities that put pressure on the foot, especially the big toe.

However, bear in mind that the only definitive treatment for bunion is bunion surgery. Bunions that are left untreated will likely get bigger and cause more pain. The purpose of surgery is to fix the alignment of the big toe. If these home remedies fail to provide relief, then it may be time to see a podiatrist. Modern and virtually painless treatments are now available, as well as scarless bunion surgery.