A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

What can I expect before surgery?

Bunion surgery generally involves an incision in the top or side of the big toe joint and the removal or realignment of soft tissue and bone. This is done to relieve pain and restore normal alignment to the joint. If the joint is severely deformed, it may be stabilized with tiny wires, stitches, screws, or plates. There are no guarantees that a bunion surgery will fully relieve your pain. A regional anesthetic that affects only the foot is commonly used for bunion surgery. A sedative may also be used during the procedure. The procedure usually takes an hour or more, depending on the type of surgery. Bunion repairs are usally done on an outpatient basis. There are over 100 surgeries for bunions. Research does not show which type of surgery is best and needs to be specific to your condition. More than one procedure may be done at the same time. The general types of bunion surgery are: Removal of part of the metatarsal head (the part of the foot that is bulging out). This procedure is called exostectomy or bunionectomy. Realignment of the soft tissues around the big toe joint. Removal of a small wedge of bone from the foot or from the toe. Removal of bone from the end of the first metatarsal bone, which joins with the base of the big toe. At the big toe joint, both the big toe and metatarsal bones are reshaped. Fusion of the big toe joint. Fusion of the joint where the metatarsal bone joins the mid-foot. Implant insertion of all or part of an artificial joint.

What can I expect after bunion surgery?

If you are about to have bunion surgery, you are probably wondering, "What can I expect after bunion surger?" It is important to note that not all bunion surgeries are deemed a success by the patients who undergo them. Surgery does not always correct the problem in about 33% of the cases. Whether or not the surgery is successful, there are a number of things a bunion surgery patient can expect after surgery, including: You will need to stay off of your foot most of the time for up to eight weeks after bunion surgery. Stitches may be removed within the first few weeks after surgery. Your range of activities will be limited for a long time after surgery: it may require months or even a year of healing before certain athletic activities can be resumed.

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