Once a bunion has developed, you can often slow the rate of progression with conservative care, but you might not be able to stop it. Eventually, this might make surgery inevitable. This does not mean your bunion needs surgery right now, or that you should just get it over with.
By contrast, we always encourage our patients to exhaust conservative treatment options first. Although this will not correct or fix the alignment of your feet, early intervention and conservative treatments can keep your feet mobile and pain free for as long as possible. Common methods can include:. Contrary to popular belief, simply shaving existing calluses is not an effective treatment. The calluses form due to friction and pressure.
Thinning them will not remove the source of the friction. Unfortunately, most people do ultimately reach a point where conservative treatments are no longer working and surgery is likely the best option. Well, remember that any surgery will come with specific needs for post-operative recovery and rehab.
And a foot surgery will place some restrictions on your mobility for a time. We will teach you how to keep weight on your heel and modify your gait pattern so that you can continue to go about your day as best as possible. By far the most common cause of bunion surgery complications is patients not following their directions within the first two weeks. As a result, we encourage you to do all you can to make the transition as smooth and easy as possible. If you have friends and family members who can be available in those first few weeks to help you with daily tasks, ask them for assistance.
You may have limited toe motion. The bunion may come back. You may feel numbness, tingling, or burning in your toe. You may still have pain and swelling, especially if you don't wear roomy shoes.
Even after surgery, your foot may not look completely normal. All surgery has risks, including bleeding, nerve damage, and infection. Your age and your health can also affect your risk. Don't have surgery Don't have surgery You wear roomy shoes and avoid activities that put pressure on your toe and foot.
You use bunion pads, arch supports, or custom-made supports orthotics for protection and comfort. To relieve toe pain, you can try over-the-counter medicine such as ibuprofen or aspirin. You can decide to have surgery later if you feel you need it. Using other treatments may relieve your pain, allowing you to do your daily activities. You avoid the risks of surgery.
You will still have a bunion. Your pain and deformity may be so severe that you can't do your daily activities. Personal stories about surgery for bunions These stories are based on information gathered from health professionals and consumers.
What matters most to you? Reasons to have surgery for bunions Reasons not to have surgery. I'm not very worried about the risks of bunion surgery. I'm worried about the risks of bunion surgery. I'm in pain and can't do my daily activities. My other important reasons: My other important reasons:. Where are you leaning now?
Having bunion surgery NOT having surgery. What else do you need to make your decision? Check the facts. Yes Sorry, that's not right. Surgery for bunions isn't usually done unless you've already tried other treatment and it didn't relieve your pain. Other treatment includes wearing roomy shoes and using pads and supports. No You're right. I'm not sure It may help to go back and read "Key points to remember. I'm not sure It may help to go back and read "Get the Facts.
If you have pain only now and then, surgery may not be right for you. But if your toe is too painful, if your deformity is too great, or if you can't easily do your daily activities, you might think about surgery.
Decide what's next. Yes No. I'm ready to take action. I want to discuss the options with others. I want to learn more about my options. Your Summary. Your decision Next steps. Your knowledge of the facts Key concepts that you understood. Key concepts that may need review. Getting ready to act Patient choices. What matters to you. Print Summary. Credits Credits. Get the facts Compare your options What matters most to you?
Get the Facts Your options Have bunion surgery. Compare your options Have bunion surgery Don't have surgery What is usually involved? The procedure takes about an hour, depending on the type of surgery. You wear roomy shoes and avoid activities that put pressure on your toe and foot. Check the facts 1. Is surgery the first choice for treating bunions? Yes No I'm not sure. You're right. Is surgery right for you if you have occasional toe pain?
Decide what's next 1. Do you understand the options available to you? Certainty 1. Check what you need to do before you make this decision. Note: The "printer friendly" document will not contain all the information available in the online document some Information e. Top of the page. Current as of: March 2, When the bunion is irritated and painful, warm soaks, ice packs, and nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen may help. Whirlpool, ultrasound, and massage may also provide some relief.
Cortisone injections can relieve pain temporarily by reducing inflammation, but they have many side effects, especially when used often and at high doses. American Podiatric Medical Association www. American College of Foot and Ankle Surgeons www. American Academy of Orthopaedic Surgeons www. Foot Health Facts www. If conservative measures fail and you still have pain that interferes with daily activities, you may need surgery to restore the toe to its normal position.
Never undertake bunion surgery merely for cosmetic purposes, and never rush into it. You won't necessarily get rid of all your symptoms, and you'll have to stay off your foot for many weeks. Complete recovery can take a year or more, depending on the procedure. As with any surgery, you'll want to make sure the surgeon is experienced in performing the particular operation you've decided to undergo.
You may also want to talk to other patients who've had the operation. The aim of surgery is to relieve pain and restore normal function by eliminating the bony protuberance and realigning the joint including ligaments, tendons, and nerves. There are more than surgical procedures for bunion correction, but few of them have been evaluated or compared in controlled trials.
The surgeon will take x-rays and make measurements that help classify the bunion as mild, moderate, or severe. She or he will also take into consideration your age, activity level, and health and the strength of your bones and connective tissue.
The more severe the bunion, the more complicated and risky the surgery. For mild deformities, the surgeon will probably choose bunionectomy — shaving off the enlarged portion of the bone and realigning the muscles, tendons, and ligaments see "Bunion surgery by category".
For moderate deformities, it may be necessary to cut the bone close to the metatarsal head in order to shift it back into its proper position.
To correct severe bunions, the surgeon makes a cut at the base of the metatarsal bone, rotates the bone, and fixes it in place with pins or screws.
Cutting and repositioning the bones is called an osteotomy. Bunionectomy and osteotomy may be performed under local, general, or spinal anesthesia on an outpatient basis in a hospital, surgical center, or doctor's office, usually by an orthopedic, podiatric, or other specialist foot surgeon. Some of these surgeries can be performed using minimally invasive techniques. None of them will reshape your foot to fit into the kind of narrow shoes that may have created the problem in the first place.
Shaves the bony excess on the outside of the metatarsal head. Realigns the muscles, tendons, and ligaments surrounding the joint.
Recovery takes 3—4 weeks and usually involves wearing a postoperative shoe. May not correct the deformity that caused the bunion. Same as for a mild bunion, plus osteotomy cutting of the metatarsal head to shift it into proper alignment. The bone is held in place with screws or pins. Recovery takes 4—6 weeks, depending on the procedure. You may need to wear a short cast and use crutches.
Cuts away the bony excess at the head of the metatarsal bone. Removes a wedge-like piece of bone and realigns the metatarsal, which is secured with screws or pins. Corrects tendons and ligaments. Recovery takes 6—12 weeks. If the joint is beyond repair, it may be replaced with an artificial joint. Variations among toe-joint deformities and surgical techniques make it difficult to evaluate the results of bunion surgery. The problem may be unrealistic expectations.
Some patients mistakenly believe that after surgery, the big toe will be completely straight and the foot will fit into narrower shoes. James P. Ioli, chief of podiatry at Brigham and Women's Hospital in Boston. Patients may also expect faster relief from pain and swelling than the procedure allows.
0コメント