Preventative measures can be used for some people, but because most cases are inherited, he recommends that for those with a predisposition for bunions, the condition be monitored annually using X-rays. When conservative measures, such as special shoes and pads, aren't halting progression of the deformity, he says surgery is the answer.
"You need to have surgery done before arthritis develops and before it's too late for new procedures to correct the problem," says Hutchinson, adding that just removing the bump won't do the trick. Anyone with a severe misalignment of the toe or indications that it is progressing rapidly to that end needs an operation that will correct the angle of the toe bones. This includes those who previously had surgery that did not correct the problem.
When surgery is done correctly, reoccurrence of the bunion is less than 5%, Hutchinson says.
The surgery includes cutting and realigning the bone and correcting alignment of adjacent ligaments and tendons. If the joint already is arthritic, meaning that the cartilage has deteriorated, then the joint probably will have to be replaced with an artificial one or it will have to be fused, experts say.
Scott Ashton, DPM, a podiatrist at Medical City Dallas Hospital, agrees that just removing the bump is only cosmetic.
"A bunion is caused by an increase in the angle between the two lower bones of the big toe," Ashton tells WebMD. Surgery is definitely called for if the angle between the toe bones is more than 12%, and he often sees patients whose angle has reached 18-20%.
"The key to correction is to close the joint angle to less than 8%," Ashton says. From a technical standpoint, he believes anyone can have the surgery unless they have major health problems, for instance, "soft bones" or some other condition that would make it difficult to recover and go through rehabilitation. He has done surgery for people as young as 11.
"From a strictly technical standpoint, it can be done on any age," he says. But he cautions that in the case of a youngster, care must be taken not to disturb the growth plates.