All About Bunions

Hi If your bunion is painful, there are several ways to try reduce the pain. One way is medication: anti-inflammatories. You can take some to reduce the inflammation and pain. This may not be permanent, and you may have to continue taking it as necessary. Bunion straps/ spacers are another alternative, to help reduce the degree of deformity and hence reduce the pain. Finally, if all the above do not work, you may want to consider surgical correction. Different methods of correction are available, depending on the severity of the bunions. Hope the above helps.

Bunions get progressively worse with time. They do not reverse, and it really just depends when you want to get them corrected. An example of a normal toes vs overlapping toes: It is an anatomical and genetic problem, and they will not be able to reverse and go back to the normal shape. Please read this post (When should I have bunion surgery, and what will happen if my bunions are not removed) to find out more about the problems of delayed treatment. If a patient is not keen for surgery, or not suitable for surgery (e. g. poor health), an alternative would be to use bunion straps.

Bunion surgery is done via either the traditional open method or a keyhole/ MIS method. It depends on the severity of the bunion, and what technique the surgeon is competent and proficient in. My first option would always be to offer a keyhole correction for a patient if I feel the bunion is suitable for such correction. The advantages for keyhole surgery are plenty. Please refer to this post What are the best treatment options for bunion removal in Singapore and How can I find the best doctor for bunion surgery in Singapore to find out more about keyhole correction.

Pain is very subjective. On a scale of 1-10, patient A’s pain score of 2 may be patient B’s score of 7. Nonetheless, there are ways to try reduce the discomfort and pain. Pre-operatively, the surgical technique would be the most important. Why would someone opt for a wound that is 8-10cm long, compared to one which is 1-2cm long? Example of a open scar: I would expect more pain from a longer and larger wound. Post-operatively, we would give medication to reduce inflammation and pain, and this helps in pain control and relief.

Pre-operative investigations and fitness for surgery are of utmost importance. This is to ensure that the patient is suitable for surgery, and that both the surgeon and the anesthetist are comfortable with proceeding with the surgery. Investigations would include blood tests, ECG, chest X-ray and any other investigations deemed necessary by the surgeon and/or anaesthetist. If one is planning for surgery, another good tip of course would be to do things to reduce the chances of the bunion getting worse, whilst waiting for the surgery.

If MIS surgery is done, the benefits would include less pain, less bleeding and less risk of infection. The hospital stay is also shorter. It has as good a result as traditional open surgery (published results in international journals just last year). Pain is definitely less than traditional open surgery, and I have had patients who even do not complain of any pain at all. Patients would be able to weight bear the same day after surgery, in a special post-operative surgical sandal. So they would be able to ambulate straight away. There is no need for any casting/ plaster of Paris.

Hi Joce Thank you for your question. From the pictures, your bunions are definitely suitable for minimally invasive (MIS) / keyhole surgical correction. I would have to examine them more thoroughly and look at the X-rays to be doubly sure. A painful bunion is an indication for surgery, and from your description, it seems that they are bothering you alot. MIS correction would definitely be useful, and benefits include lesser pain, less risks of infection and bleeding. They are also cosmetically much more presentable.

Thank you for your question. It’s something I get asked very frequently. Unfortunately, the answer would be a big emphatic yes. 90% of bunions are genetic (do see your mother’s, grandma’s, sisters or female cousins feet). Most people would try things like strapping, toe spacers etc. All these will not work in the end, and the deformity reverts once they are removed. Bunions usually progress with time, and left untreated, they will start affecting the adjacent toes, gait, and cause generalised foot pain or deformity.