Most bunions can be treated without surgery. But when nonsurgical treatments are not enough, surgery can relieve your pain, correct any related foot deformity, and help you resume your normal activities. An orthopaedic surgeon can help you decide if surgery is the best option for you. Whether you've just begun exploring treatment for bunions or have already decided with your orthopaedic surgeon to have surgery, this booklet will help you understand more about this valuable procedure. Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person. Not only are the angles that form the bunion important, but the actual condition of the joint itself is also very important. If the cartilage making up the joint is too far eroded then even a procedure that creates perfect alignment of the joint is still going to be problematic for the patient. It is at this point that the surgeon has to decide to either remodel the joint or replace the joint with an implant or artificial joint. Unfortunately, the only real way to know the actual condition of the joint is to visually inspect it, once the foot is open. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men. Some shoes can be modified by stretching the areas that put pressure on your toes. Splints to reposition the big toe and orthotics (special shoe inserts shaped to your feet) also may relieve pain. For bunions caused by arthritis, medications can be prescribed to reduce pain and swelling. Dr. Prateek Gupta M.S., M.ch-orth(Livepool),FICS(USA), D.Orth.(London), F.R.C.S - Orth(London), Consultant Orthopedics & Sports Surgeon. Sir Gangaram Hospital, New Delhi, India. When the above non-surgical treatment options have not worked, the health care provider will suggest undergoing a bunion surgery to correct the dislocation. The surgery can be performed by an orthopedic surgeon, who will loosen the tight tissues and shorten the long ones, so as to repair the tendons and ligaments present around the toe. Severe bunions can be corrected with the use of wires, plates and screws. There are different types of surgical procedures and the best procedure for you will be told to you by your surgeon. Bunion surgeries cannot be guaranteed for a total recovery. Often calluses and corns are developed as post operative complications. Orthotics, custom orthopedic foot supports, can help with mild hammer toes and bunions. They aren't a cure, but orthotics can make certain types of shoes more comfortable. Orthotics may slow down or perhaps prevent the progression of bunions and hammer toes. However, once the hammer toes and bunions become too large or severe an orthotic becomes just another thing occupying space in a crowded shoe. How does the nursery rhyme go? There was an old lady living in a shoe with so many hammer toes and bunions she didn't know what to do. Treat the pain with pain relievers, use pads to cover the bunions, buy shoe inserts, or surgery may be an effective option for you. Avoid wearing high heels and wear roomy shoes for comfort. Corn and calluses are dead thickened skin that is caused by friction. The thick skin forms to protect the sensitive skin on the foot. These will go away when you reduce the friction of the irritated area. Moleskin pads can eliminate corns and calluses can be trimmed or surgically removed. Other related procedures that may be used to help diagnose foot disorders include X-rays of the bone and foot. Please see these procedures for additional information. A bunion is an enlargement of bone or tissue around the metatarsophalangeal (MTP) joint of the great toe. It's often caused by patients wearing shoes that are too narrow around the toe box and can cause pain and deformity of the toes. If the patient's great toe is not overlapping or impinging upon the second toe, but he still has an obvious bunion, take a look at 727.1; this code specifically says 'bunion' and the ICD-9 definition is "enlarged first metatarsal head due to inflamed bursa; results in laterally displaced great toe." There is some controversy in the medical community about the benefit of physical therapy after surgery. I do not send all my patients for physical therapy; in fact in many cases I will just give them instructions in exercises and other things they can do at home to facilitate their healing (and only hope they actually follow my instructions). If after reading this page you are still "up in the air" as to what you should do about your bunion, may I suggest you visit the following web site for a personal account of one person's experience with a variety of non-surgical bunion treatments The bunion experiment TAILORS BUNION A bunion is caused by an abnormality in the position of the bones in the foot and big toe. Instead of being in line, meeting flatly end-to-end, the bone along the inside of the foot (the first metatarsal) and the first bone of the big toe ( hallux ) meet at an angle ( valgus deformity). The only way that they can be corrected is by surgery. In the past, surgical operations had meant being off one's feet and in plaster for up to three months. Called osteotomy, this conventional surgery involves cutting out a piece of bone and repositioning the two ends to try and straighten the toe.