A bunion is a deformity of the big toe that can be very painful. Bunions cause the big toe to turn outward. The tissue around the joint and at the base of the big toe become swollen and enlarged and cause a bump. The majority of bunions can be treated without surgery. But when non-surgical treatments are not enough, surgery can relieve your pain, correct any related foot deformity, and help you resume your normal activities. An orthopedic surgeon or podiatrist can help you decide if surgery is the best option for you.

Anyone who experiences symptoms from bunions should see a podiatrist or orthopedic surgeon for treatment. But you may benefit from surgery if you have any of the following:

• Severe foot pain that limits your everyday activities, including walking and wearing comfortable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain.
• Chronic big toe inflammation and swelling that doesn't improve with rest or medications.
• Toe deformity - a drifting of your big toe toward the small toes.
• Toe stiffness - inability to bend and straighten your toes.
• Failure to obtain pain relief from anti-inflammatory drugs.
• Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medications.

There are several non-surgical treatments available to help reduce the pain and the deformity associated with bunions. If you have corns or calluses that are causing symptoms, you should have them treated by an orthopedic surgeon or podiatrist. Non-surgical treatments include:

• Padding to reduce pressure on the painful portion of the bunion.
• Physical therapy can be used to help with the symptoms and improve the range of motion. This is particularly helpful if the pain is coming from inside the joint, rather than from shoe pressure). Manipulation of the joint can be used to help with this (manipulation will never correct the alignment of the joint.
• Foot orthotics may be useful in helping with the instability about the joint.
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Exercise can be important in maintaining the mobility of the joint.
• Proper shoe fit is important. Avoid tight-fitting shoes, especially women's dress shoes.

Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

• Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
• Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
• Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
• Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

Almost all bunion surgery is done on an outpatient basis. You will be asked to arrive at the hospital or surgical center one or two hours prior to surgery.

After admission, you will be evaluated by a member of the anesthesia team. Most bunion surgery is performed under ankle block anesthesia, in which your foot is numb, but you are awake. General or spinal anesthesia is used occasionally. The anesthesiologist will stay with you throughout the procedure to administer other medications, if necessary, and to make sure you are comfortable.

The surgery takes about an hour. Afterwards, you will be moved to the recovery room. You will be ready to go home in one or two hours. You can expect the following after your procedure:

• Your toe will be held in a corrected position with dressings upon discharge and you will wear a cast or a special shoe to protect your foot. Continued support from dressings or a brace will be needed for six to eight weeks.
• Your sutures will be removed two weeks after your surgery.
• Your doctor may recommend that you use crutches, a walker or a cane the first week after surgery. Over time you may put more weight on your foot. Walk only short distances the first few weeks.
• Keep your foot elevated for the first few days following surgery and apply ice to relieve any swelling. You can expect swelling for about six months.
• Wear only athletic shoes or soft leather shoes for the first several months after surgery. Do not wear high heels or other uncomfortable heels until at least six months.
• You may drive again within a week.
• Your doctor may recommend physical therapy to restore range of motion and strength.
• Your doctor may prescribe antibiotics to prevent infection and mediation to relieve pain.

A variety of factors may influence the cost of the surgery. They include:

• Insurance coverage
• Pre-existing health
• Insurance co-pay
• Location of the facility

These factors vary depending on you and your situation.

The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. HealthGrades provides detailed cost estimates which include the costs of the procedure, drugs, hospital stay, and more. Each cost estimate is easy to understand and provides medical terms you need to know.

The detailed cost estimate for Bunion Correction, includes costs for:

• Surgical removal of bunion including such procedures as: McBride, Keller, Mitchell, and Lapidus
• Release of soft tissue
• Removal of joint with/without joint implant
• Tendon release or transplants
• Incised metatarsal joint
• and incised phalange.