Even though bunions are obvious from the pain and unusual shape of the big toe, further diagnosis is wise.
A doctor will usually take X-rays to determine the extent of the deformity. Blood tests may be advised to see if a type of arthritis may be causing the pain. Based on this evaluation, your doctor can determine whether you need orthopedic shoes, custom made inserts, medication, surgery, or other treatment.
To treat bunions, your doctor may recommend a prescription or over-the-counter pain reliever, as well as a medication to relieve swelling and inflammation. A heating pad or warm foot bath may also help relieve the immediate pain and discomfort. A few people may find relief with ice packs.
If the bunion isn't persistently painful and you catch it early, changing to well-made, well-fitting shoes may be all the treatment needed. Some doctors advise bunion pads, splints, or other shoe inserts, provided they don't exert pressure elsewhere on the foot and aggravate other problems.
In some cases, an orthotic specialist can prescribe shoes with specially designed insoles and uppers that take the pressure off affected joints and help the foot regain its proper shape.
Surgery may be recommended for some bunions, but only when symptoms are severe enough to warrant such intervention. Surgery for strictly cosmetic reasons should not be done since the risks may be greater than the benefits.
Surgery for a bunion, called a bunionectomy, is done in a hospital or a surgery center under local anesthesia with sedation or general anesthesia. The surgeon can often realign the bone behind the big toe by cutting the ligaments at the joint. For a severe bunion, you may need to have the bone cut in a technique called an osteotomy. Wires or screws may be inserted to keep the bones in line, and excess bone may be shaved off or removed. Some of the potential complications of surgery include recurrence of the bunion, inadequate correction, overcorrection (the toe now points inward), continued pain, and limited movement of the large toe. Some bunions may be secondary to another deformity, like flat feet, therefore the primary deformity needs to be addressed first.