My foot is “the ugliest foot you’ve ever seen”!! That is the mantra of patients with bunions and hammertoes. These deformities can make feet appear unsightly. But, most importantly with bunions and hammertoes is whether they hurt. Is it difficult to fit into sensible shoes without pain or irritation? The fact that something is not “aesthetically” beautiful, in my opinion, is not enough reason for surgery. Conservative options should be tried before surgery. After all, corrective surgery often requires prolonged recovery, time out of work, and is not guaranteed. A well-informed person is the best patient!
Bunions are “bumps” or “knobs” on the inner side of the foot, just below the big toe, that can be irritated by shoe gear. The bumps can get beet red from shoe pressure and the joint can hurt when the great toe is flexed. Hammertoes are toes that are bent and do not “straighten out”. They sometimes develop a corn or irritation where the top or side of the shoe rubs the “knuckle” or bent joint on the toe.
Conservative treatment for bunions and hammertoes can be as simple as wearing the proper size shoe in length and width in a reasonable style, heel height not to exceed two inches and always with a rounded toe box, not tapered. Protective pads can be worn over irritated skin to protect it from shoe friction. Orthotics can be prescribed to improve foot function by taking pressure off the inner side of the foot reducing “bump” irritation and pain. Studies have shown that orthotics can even slow down the progression of bunions to prevent worsening or recurrence of the deformity, whether surgery is performed or not.
Surgical treatments for bunions vary from simple to complex depending on severity of the deformity. Return to work following simple surgery can be as short as 2 weeks, for complex surgery, it can be as long as 3 months of rest, crutches, casts and/or surgical shoes. Hammertoe surgery usually heals more quickly with a return to normal function by 2 weeks. While these surgeries are highly successful, there are no guarantees that your feet will now be modeling on the pages of a fashion magazine. Some mild residual deformity may remain. Your expectations of surgery and the post-operative recovery period must be realistic.
For any of these deformities, it is best to consult with a podiatric physician where you can discuss all treatment options. A word of caution: before you undergo elective surgery, try to understand ALL of your options and consider conservative treatments first. You can always undergo surgery later. I am happy to explain and try various options with my patients to find their comfort level.