As sandal season arrives and warmer weather encourages more time outdoors, many people become increasingly aware of a painful and often frustrating foot problem: bunions. While some patients are bothered by the appearance of the bump on the side of their foot, the real issue is often the discomfort that can make walking, exercising, and wearing certain shoes difficult.
Fortunately, advances in foot and ankle surgery have transformed the way bunions are treated. Minimally invasive bunion surgery allows surgeons to correct the deformity through small incisions, helping patients experience less pain, smaller scars, and a faster recovery than traditional techniques.
To learn more, we spoke with foot and ankle specialist Dr. Christopher Lotufo about what causes bunions, when surgery may be appropriate, and how minimally invasive techniques are changing patient outcomes.
What Exactly Is a Bunion?
According to Dr. Lotufo, a bunion is much more than a bump on the side of the foot.
“Your first metatarsal bone starts to migrate outward. As it migrates outward, your big toe goes the opposite way, and then a bump appears. That gets larger over time.”
While many people associate bunions with aging, they can affect patients of all ages.
“There’s such a thing as juvenile bunions. They’re born with it and may start having problems when they begin playing sports or wearing athletic shoes,” he says.
What Causes Bunions?
The biggest factor is genetics – it’s heredity, mostly. However, footwear can contribute to the progression of the deformity. Most patients first notice discomfort when the bunion begins rubbing against closed-toe shoes.
“Those pointy-toe shoes that a lot of professional women like to wear can cramp the toes and cause the bunion to become larger over time,” says Dr. Lotufo. “Bunion pain usually starts out as what we call bump pain. The shoe rubs on the bump, it gets a little red, it starts to hurt, and that’s where most people start to seek advice.”
When Is It Time to Consider Surgery?
Not every bunion requires surgery. In fact, Dr. Lotufo often recommends conservative treatment first.
“If you’re just starting out having pain with your bunion, the best thing is to wear a wider shoe and try to avoid shoes that really put pressure on it. There’s lots of devices out there that claim they can fix your bunion if you wear it at night, but they really just provide some pain relief. They don’t really do anything to fix it,” he says.
Orthotics and shoe modifications may provide relief for some patients, but they don’t correct the underlying deformity. For many patients, the decision comes down to quality of life.
“If the bunion is affecting your quality of life—if you’re not taking those walks with your friends or you’re not playing the sports you want to play because you’re thinking about whether your bunion is going to hurt—fix it.”
How Does Minimally Invasive Bunion Surgery Work?
Traditional bunion surgery often required larger incisions and significant soft tissue dissection. Today’s minimally invasive techniques allow surgeons to achieve the same correction through much smaller openings. Using specialized instruments and fixation devices, surgeons can realign the bones while minimizing disruption to surrounding tissues.
“We’re now able to correct fairly large bunions through small pinhole incisions where we make the bone cuts,” he says. “There are specialized screws and hardware that we use now to fixate those bones so they can stay stable.”
Because less tissue is disturbed during surgery, patients often experience a more comfortable recovery. That leads to less recovery time and less pain because you’re not making large incisions and disrupting tissues.
What Is Recovery Like?
One of the most common questions patients ask is how soon they can get back on their feet. The good news is that most patients are able to walk immediately after surgery. Patients will typically wear a surgical shoe, walking boot, or CAM walker while the bone heals.
“You’re generally walking immediately. You don’t have to really stay off your foot,” says Dr. Lotufo. “That’s until the bone heals, which can be six to eight weeks. But for the most part, you’re walking right away with most minimally invasive bunion surgery.”
Will the Bunion Come Back?
There’s good news! When properly corrected, recurrence is uncommon.
“Fixing the bunion requires realigning the joint, and if you get the joint realigned properly, it generally should last a lifetime,” he shares.
Take the Next Step
If bunion pain is keeping you from enjoying walks, exercising, traveling, or simply wearing the shoes you love, minimally invasive bunion surgery may be an option worth exploring. The foot and ankle specialists at Center for Sports Medicine & Orthopaedics can help determine the best treatment plan for your specific condition and lifestyle goals.
