When is the right time to have bunion surgery

When should you consider operating on bunions?

Sam: So I think the key thing here is that if a bunion doesn't hurt, it doesn't need surgery, okay. So, we treat bunions when they hurt, and they can hurt in many ways. They can hurt because they rub on the shoe, and they get inflamed, and they can become very tender. And we then typically see that big bump on the inside of the shoe.

But also they can ache within the joint, and sometimes, say for example, people get home and they're just desperate to get their shoes off because their feet are just throbbing. It's not an agonising pain, but it is just a discomfort that doesn't go away.

Why does numbness occur in the toe?

Sam: The other thing is that you can sometimes get numbness in the toe, which is quite unnerving for patients because the nerve gets squashed between the bone and the skin. So the nerve gives them a bit of tingling in the tip of the toe and that can be quite unpleasant.

Why are other toes affected by bunions?

But sometimes what happens is because your foot is so deformed, you start getting problems with the other toes. So for example, you'll see people getting claw toe, or hammer toe deformities where the other toes start to hook up, that can cause problems. Sometimes you get things like a stress fracture or inflammation in the joint. These are relative other indications to do something about your bunion.

Can you wait too long before having surgery?

Sam: If your bunion hurts and if you leave it too long, you develop other problems in the foot. We get very good results when we are just treating the big toe. But what we know is that when we have problems with the lesser toes, for example, when those lesser toes are getting inflamed or people are developing a claw type deformity - a hammer toe - in the other toes, the surgery results are never as good. So you really do want to, if you can, nip the problem while it's just isolated to the big toe.

Mr Sam Singh has been lead foot and ankle surgeon at Guy's and St Thomas' NHS Foundation Trust. He performs large volumes of foot and ankle surgery annually and has a special interest in bunion surgery. His private practices in London are located at: London Bridge Hospital (with outpatients at HCA at The Shard and 31 Old Broad Street in The City) and The Lister Hospital.