A bunion is a bony bump on the joint at the base of your big toe. The bony growth on the joint sometimes causes your big toe to turn in towards your second toe.

Symptoms include pain, swelling of your big toe and, as the bunion sticks out, it can often rub on the inside of your shoe.

The cause is not always known – there may be a deformity of the joint, called hallux valgus (hallux means big toe, valgus means bent outwards). Or it can be as simple as ill fitting footwear not allowing enough width to fit the toes in their natural position. Sometimes bunions are associated with arthritis in the joint at the base of your big toe. Left untreated bunions can continue to grow and become more painful.

Treatment can help ease the pain. You can wear good supporting footwear – narrow, pointed shoes are best avoided. Painkillers can help, as can comfortable insoles and padding over the bunion. However, surgery is most effective if symptoms are not easing. The operation to remove bunions is called a bunionectomy.

Bunion surgery can be performed under local or general anaesthetic. The operation usually takes between half an hour to an hour.

There are several types of bunionectomies. Some involve removal and realignment of the bones in your foot. Mild bunion problems can sometimes be resolved using soft tissue release or tightening. For some very severe cases bones of the big toe are fused or the bunion is cut out along with some of the bone at the base of the toe. Be sure and discuss which type of operation you will have with your surgeon.

With any type of bunionectomy your surgeon will make one or more incisions (cuts) near your big toe. They will use instruments to trim the bones and remove the bunion. Wire, screws or plates may also be used to hold the new joint in place.

Depending on what procedure is used you should be able to go home the same day of the surgery. In some cases an overnight stay is required. Discuss your length of stay with your surgeon.

You may need to wear plaster cast or dressing. You will be given a surgical shoe so you can walk on your heel. You will need crutches to move around.

In the first few weeks following your operation your foot and ankle will be sore and swollen. You will need to spend most of your time with your leg raised so that the swelling settles.

You will not be able to wear normal footwear for at least three to four months after surgery. When you do transition to normal shoes it is recommended they wide fitting and have low heels. Avoid any narrow, high heeled shoes that might put pressure on the surgical area.

Cheilectomy is a procedure offered by consultants to treat Hallux Rigidus (stiffness and pain in the big toe, usually caused by arthritis). Hallux rigidus is stiffness and pain in the big toe joint while walking. It is usually caused by arthritis and can affect patients of all ages. Often patients lose the ability to lift their big toe upwards. Or the toe becomes so stiff that it cannot lie flat in your shoe.

A bony bump may form on the top of the toe joint causing further movement restriction and pain. Your consultant may try conservative treatment including such as prescribing pain relief or anti-inflammatory medication or steroid injections. If conservative treatment is not successful your consultant may recommend a cheilectomy.

A cheilectomy can be performed under general or local anaesthetic. Your anaesthetist will discuss the method to be use with you prior to your surgery.

Your consultant will make an incision (cut) on the side of your big toe. They will remove the bony bump and flush out your big toe joint. Your surgical wound will be closed with stitches and dressings will be applied.

You may be given additional local anaesthetic for pain relief. You will also be given tablets for pain relief. A cheilectomy is usually performed as a day case meaning you will be able to go home the day of your surgery.

Osteotomy is usually performed under general anaesthetic. During this procedure a bone is cut to shift the weight of an area away from where there is damaged cartilage to an area where the cartilage is healthy. In some cases bones are held into the correct position with rods or screws.

This can affect various areas of the foot, and the operation may be slightly different for each area, such as mid or hind foot.