The most common cause of bunions is footwear that does not have enough width to fit the toes in their natural position. High heels are particularly to blame as they squash the toes into the narrowest part of the front of the shoe.



Bunions are more common in women than men, and a tendency to get them can run in families. They are occasionally associated with arthritis of the joint at the base of the big toe but many people with bunions have no underlying joint problems.

There are very few occasions where bunion surgery is the only option. The main alternative to surgery is to adapt your shoes so that they fit comfortably.

The options depend on how severe the bunion is. Using extra-wide-fitting shoes from a good- quality shoe shop may be enough. If not, the surgical appliances department at the hospital will be able to give you advice about stretching shoes or ordering a custom-made pair to fit the shape of your feet comfortably.

These shoes are not usually particularly fashionable, but they avoid all the risks of an operation and are almost always an effective treatment.

Bunions do not get better without surgery. Most bunions will get worse with time. Wearing sensible footwear will usually prevent them from getting rapidly worse. The skin over the bunion can become inflamed where it rubs on the inside of the shoe.

Very occasionally it can get infected and cause an ulcer. Aching in the foot is common but this is due to other related problems with how the foot works rather than the bunion itself.

A variety of anaesthetic techniques are possible. Your anaesthetist will discuss the options with you and will recommend the best form of anaesthesia for you.

There is a wide range of different operations for bunions, depending on the size of the bunion, the amount of deformity of the big toe, other associated problems with how the foot works, and any arthritis. The operation will involve removing the bunion.

It may involve other procedures to cut and realign the bones of the big toe and to tighten stretched ligaments around the big-toe joint. You may also need to have an operation to straighten one or more of the other toes at the same time.

Your surgeon will discuss with you how much surgery you will need. At the end of the operation, your surgeon will close the skin with stitches.

Bunions are very common. For those people who are not able to cope with adapting their footwear, surgery gives a good chance of making their feet fit comfortably into normal shoes and improving the cosmetic appearance.

Surgery is usually safe and effective. However, complications can happen. You need to know about them to help you make an informed decision about surgery. Knowing about them will also help to detect and treat any problems early.