Ask Dr. Klein

Question: 
I have bunions, but my feet don't hurt. My sister says that I should have them fixed before they become worse. Is this true?

Answer:
Many people have bunions, but not all bunions are painful. A bunion is more than a "bump" on the side of your foot. It is a deformity of the great toe that frequently runs in families. If bunions run in your family, you may be predisposed to developing a bunion over time. Bunions range from mild to severe and are most common in populations of people who wear shoes.

In fact, shoe wear plays a significant role in the development of a bunion deformity. Bunions can worsen over time and become painful if your shoes are not an adequate width for your foot. High-heeled shoes also influence the development of a bunion by increasing pressure on the forefoot. As bunions become worse, they can become painful or the lesser toes can become painful.
Many bunions do not become painful or change over time. With appropriate shoes, bunions can remain stable and may not limit your activity level. The primary indication for surgical treatment of a bunion is pain. If you are having pain that limits your ability to wear most shoes and limits your activities, you may consider surgical correction of your bunion. If you are not having pain, there is no reason to correct a bunion today due to concerns that it may become worse in the future.

Surgical treatment for bunions usually involves an osteotomy, or a cut in a bone to realign the great toe. Sometimes multiple osteotomies are necessary to correct the deformity. The surgical treatment depends on the
specific deformity causing the bunion and may vary from person to person. If hammertoe deformities of the lesser toes develop, these are often corrected at the same time. If you have foot pain related to a bunion, an orthopedic foot and ankle surgeon can provide you with a surgical evaluation.