You notice the big toe on your right foot starting to lean towards your other toes. This structural shift is accompanied by foot pain and having an increasingly hard time fitting into your day-to-day shoes (1). Sometimes you even feel off balance and fear falling (1;2). You inspect your foot and identify the culprit, a bony bump that has formed at the base of your big toe (1). That’s right, the dreaded bunion!
Whether you’re 25 or 65, bunions—which are a deformity of bone and tissue—can affect anyone (1;3). That said, bunions are more common in women and as we age (1-4). In fact, about 35% of older adults experience bunions (3). Now, many of us might not consider foot health a top priority for optimal aging, but we should! If the health of our feet is in decline, we might struggle to independently complete essential daily tasks or engage in activities like exercise that help us improve our health. But, when our foot health is top-notch, we not only feel more confident in the look of our feet but also in their function.
Treating bunions is part of maintaining and improving foot health and includes both surgical and non-surgical options like splints and shoe inserts. Unsurprisingly, the initial go to treatments are the less invasive non-surgical options. However, when these fail to offer relief, surgery is the next step. Let’s look at a recent systematic review that investigated the potential benefits and harms of surgery (1).
What the researchers found
The review found some positive results that would need to be weighed carefully against potential harms with the help of a healthcare provider. For instance, compared to no treatment or non-surgical treatment, people with bunions who receive surgery may experience a meaningful improvement in pain and a slight improvement in function one year following their surgery. Unfortunately, surgery may have no effect on quality of life. Additionally, we are unable to comment on how these treatments stack up when it comes to needing additional surgeries and negative side effects that vary in severity. It’s important to note that these findings are based on only one study and low-certainty evidence, meaning that future studies are needed and may change what we see here.
While various types of bunion surgeries are available, osteotomies—which involve cuts to the bone to realign the joint and can be simple or complex—are one of the most common. Let’s compare the simple and complex approaches. Ultimately, it appears that complex and simple osteotomies are likely similar when it comes to pain reduction and may be comparable in the development of serious side effects. But with more complex surgery, we may see a greater need for additional surgeries. More research is needed around the impacts of complex procedures on function and side effects in general (1).
In the end, what the evidence really shows is that discussing the range of treatment options available with a healthcare provider is key so the pros and cons of each can be assessed and the appropriate approach chosen.
