Treatment options for bunions 

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Treatment
 Pros
Cons
Bunion pads

Bunion pads cover your big toe to stop it rubbing against your shoe
  • Readily available from pharmacies
  • No side effects or complications
  • Can reduce pain caused by bunions
  • Not always effective
  • Doesn't improve appearance of the foot
Orthotics

Devices that are placed in your shoes to help realign the bones in your foot
  • Readily available from pharmacies
  • No side effects or complications
  • Can reduce pain caused by bunions
  • Can increase your stability as you walk
  • May need to be custom-made
  • No evidence of their long-term effectiveness
  • Doesn't improve the shape of the foot
Painkillers

Painkillers, such as paracetamol and ibuprofen, can be used to treat pain caused by bunions
  • Readily available from supermarkets or pharmacies
  • Can relieve pain caused by bunions
  • Not suitable for everyone
  • Doesn't improve the shape of the foot
Suitable footwear

Wearing roomy and comfortable shoes with low heels can ease the symptoms of bunions
  • Easy to do
  • Can relieve pain caused by bunions
  • Can help stop bunions getting worse
  • Doesn't improve the shape of the foot
  • You may not like the look of the shoes

Surgery
Osteotomy

During an osteotomy, the bone is cut so that it can be placed in a certain way to help correct the deformity
  • Widely practised and proven type of surgery for treating bunions
  • Can relieve pain
  • Can improve the appearance of the foot
  • Long recovery time (possibly three to six months)
  • Bunion may return
  • Possible complications include infection, loss of feeling in the big toe, stiffness, swelling and shortening of the big toe
Arthrodesis

Arthrodesis involves fusing together the two bones in the big toe to improve alignment of the bones and reduce pain
  • Effective treatment for people with arthritis or a severe deformity
  • If fusion occurs, the deformity won't return
  • Loss of movement in the big toe, which can affect walking
  • Long recovery time
  • Can't wear high heels afterwards
  • Possible complications include infection, loss of feeling in the foot, continued pain and failure of the bones to join properly
Excision (Keller's) arthroplasty

An excision arthroplasty involves removing the bunion and the toe joint. A false joint is created by scar tissue that forms as a result of the operation
  • May be effective in treating severe deformities in elderly people
  • May be an effective treatment for people with an associated infection
  • Shorter recover time than most other types of surgery (usually about six weeks)
  • Not recommended for active and younger people
  • You won't be able to move your big toe properly afterwards
  • Can affect your ability to walk
  • Possible complications include infection, weakness in the foot, recurrence of the deformity and continued pain
  • Your big toe will be shortened afterwards
Minimal access techniques

Less invasive surgery, where small incisions are made near the big toe so that bone-cutting instruments can be inserted to correct the deformity
  • Thought to have a quicker recovery time than other surgical techniques, although this hasn't yet been proven
  • A relatively new procedure, so there's not much evidence regarding its safety and effectiveness
  • Potential risks include nerve injury, infection, toe stiffness and recurrent deformity
  • Availabilitiy on the NHS is limited