What you should know about bunions

Here are the basics of one of the most common foot problems - bunions.

Alternatives to bunion surgery
4. Bunion-removal surgery should be considered a last resort.
If you have a bunion your doctor may recommend orthotics. But they don't work for everyone. If orthotics won't resolve your problem, your family doctor may refer you to an orthopedic surgeon for an assessment. The surgeon may recommend bunion-removal surgery, one of the most frequent outpatient procedures in Canada.

No one surgery is best for every bunion problem. There are several types of bunion-removal surgeries, ranging from simple bunionectomies (cutting off the bony bump) to realignment procedures including osteotomy, a combination of bone cutting and realigning.

Post-surgery recovery time typically lasts about six weeks. During this time, in order to promote proper healing, the patient must not perform any vigorous exercise. Surgery should be performed only by a health-care professional with training in orthopedic surgical procedures.

Bunion surgery, like most surgeries, is not without risk, and even after surgery, you may still have pain or develop a new bunion. Before you have a bunion removed, consider trying other, more conservative treatments.

Alternatives to surgery

Before considering surgery, try these options to get relief.

• Buy wide, comfortable shoes. Avoid shoes with pointy toes or high heels; they only put pressure on the affected joint.

• Consider getting custom-made orthotics (shoe inserts); in some cases they may help resolve structural foot abnormalities. Orthotics fit into most types of footwear that have removable insoles. (You can't fit an orthotic over a shoe's existing insole, since it will push the foot too high up in the shoe and throw off alignment.) Your family doctor can refer you to a certified pedorthist, who will assess your foot then design, make and fit a pair of orthotics for you. Some health-insurance plans cover a portion of the cost, which ranges from $350 to $500 per pair.

• To relieve pain and reduce swelling, take an over-the-counter anti-inflammatory pain medication such as ibuprofen or acetylsalicylic acid (ASA). Ice the swollen joint for 10 minutes at a time, once or twice an hour as needed. For more information, visit the Canadian Orthopaedic Association's website or call (514) 874-9003.

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