The last bunion treatment is surgery There are different types of surgical procedures that can be performed, and most require 6 to 8 full weeks of recovery. The surgeon may cut the tendon that is pulling the joint out of alignment, then shave off the part of the bone that is protruding. A scar remains with the surgery and the redness of a bunion may still be seen in some cases. In the photo here of one 65-year-old man who had bunion surgery, the amount of correction made still left him with bunions! Since HV deformity occurs primarily in shod populations, affecting women in particular, poor footwear has frequently been cited as a cause. The fact that some women wear footwear that compresses their toes significantly without detrimental effects, while some men suffer from marked HV deformity despite the use of sensible footwear, leads many to think that footwear probably exacerbates underlying bony or mechanical abnormalities rather than acting as a primary factor. Several surgical techniques have been described for the treatment of hallux valgus and lesser toe deformities. 1-4 However, lack of agreement exists regarding which technique is the most efficacious. Bunions are often described as a bump on the side of your big toe joint. The bony prominence reflects the movement of your big toe toward your second toe and the uncovering of your metatarsal bone. This malalignment of the big toe joint produces the bunion’s “bump” which is enhanced by enlargement of the local bone. Padding/Spacers/Shields/Splints Over the counter bunion pads can be placed on the bump to minimize pain to the bump from pressure. Your podiatrist can dispense spacers/shields or splints to supply a degree of symptomatic relief. Oct 27, 2011 By Kathryn Meininger Photo Caption Hallux varus can be caused by rheumatoid arthritis. Photo Credit Comstock/Comstock/Getty Images New research determined that an increase in the severity of hallux valgus, or bunion deformity, progressively reduced both general and foot-specific health related quality of life (HRQOL). Bunion deformity was found in 36% of the study population and occurred more frequently in women and older individuals. Pain in other parts of the body beyond the foot was associated with increased bunion severity. Details of this UK population-based study appear in the March issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology. Can anyone wear a "Fit Flop"? Caution should be taken in picking any shoe. Foot type is important to evaluate. Many people with significant flexible flat feet or unstable foot type should not wear the "Fit Flop" because the destabilizing technology can actually accentuate the stress on their foot. If you require in-shoe foot orthotics, the "Fit Flop" is probably not for you. Dr Marybeth Crane is a sports medicine podiatrist and has been interviewed extensively in the last five years on the nature of flip-flop injuries. For more information on foot-related topics, visit my website at www.faant.com or my running specific website www.myrundoc.com Pain in the smaller toes can be alleviated with pads and toe straighteners. Wide, soft shoes are helpful if they give the toes enough space. Once hammer toes or claw toes have developed, however, surgery is necessary. In our experience, insoles are effective for alleviation of metatarsalgia ( 7 ). They must feature a pad that pushes the metatarsals upward proximal to the pressure-sensitive heads. It often suffices to advise the patient to wear shoes with soft soles and without excessively high heels (no more than 4 cm). The malposition of the great toe, of course, cannot be corrected with insoles alone. Occasionally there are special indications. If the distal phalanx of the great toe is angled to lateral (hallux valgus interphalangeus), osteotomy of the proximal phalanx with removal of a medial-based wedge is required (generally in addition to one of the procedures described above) ( 8 ). Absolutely accurate restoration of the angle is not possible, but if the wedge has a base of 1 to 3 mm the correction is usually adequate. Complicated and costly implants (staples, screws) are available, but adequate fixation can be achieved with a simple, inexpensive suture threaded through drill holes.