You can get bunions from:
- An inherited tendency – it is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.
- Arthritis
- Shoes with high heels or pointed toes, shoes that don't fit properly or shoes that are too tight. While the shoes don't actually cause the bunions, they sometimes make a deformity worse.
Back to top
Symptoms of a bunion are most noticeable when wearing shoes. Most often when wearing those shoes that crowd the toes – those shoes with a tight toe box and high heel shoes. This may explain why women are more likely to complain of symptoms than men. Spending long hours on your feet may also aggravate the symptoms of bunions.
Symptoms that occur at the site of the bunion may include:
- Pain or soreness
- Inflammation and redness
- A burning sensation
- Occasionally some numbness
Back to top
Early treatments are aimed at easing the pain of bunions, but they will not reverse the deformity. Early treatment options include:
- Changing shoe wear (eliminating shoes with high heels and small tight toe boxes)
- Placing padding over the bunion while wearing correct shoes
- Avoiding activities that cause bunion pain, including prolonged standing
- Medications like ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), may help to relieve pain
- Icing your bunion several times a day helps reduce inflammation and pain
When the pain of a bunion interferes with daily activities, surgical removal of the bunion may be considered and discussed with a podiatric surgeon. The severity of the deformity, your age, your activity level, and other medical conditions you may have will be taken into account in determining whether you are a good candidate for a bunionectomy (surgical removal of the bunion) and which type of bunionectomy is right for you.
Back to top
The surgery to remove a bunion is called a bunionectomy. The procedure takes about 30–45 minutes. During the surgery the surgeon makes an incision on the side of the great toe. A small piece of the bone is removed. The bone in the great toe is repositioned to correct the deformity. Sometimes a screw, pin or wire is inserted to keep the bone in the proper position. Then the incision is closed and a dressing applied.
The surgical procedure performed as part of Premier Research clinical trials is the most current bunion surgery available and is considered a standard of care procedure.
Surgery for bunion removal is typically an outpatient procedure. When you have your bunion removed as part of a clinical trial, you will be required to stay in the clinic for a longer period of time and will be closely evaluated by our trained research physicians, nurses, and other highly skilled staff. See How long will I be in the study and when do the study visits occur?
If you have more than one bunion that requires surgery, only one bunion will be removed per clinical trial. You may participate in a subsequent clinical trial with Premier Research to have a second bunion removed, but you may not participate in the same clinical trial a second time. Please discuss additional study participation with the research team.
Back to top
SCIREX Research Centers works exclusively with board certified podiatric surgeons for all of the bunionectomy studies. To learn more about our podiatric surgeons' training and years of clinical trial experience, click here.
Back to top
After the surgery it is important to keep your affected leg elevated. The research staff will make sure you are comfortable with your leg at the correct elevation while you are in the clinic.
After you leave the clinic, if you notice swelling in your foot after the first 2 days, keep your foot raised. This will help to reduce the swelling. This may be as simple as putting a pillow on a chair and placing your affected foot on the pillow. Ice may also help to reduce swelling and pain. Apply ice to the affected area 15 minutes at a time. Be sure to keep your incision dry while using ice.
Back to top
Immediately following surgery you will be placed in a private or semi-private room. You will be asked to keep your foot slightly elevated and in a podiatric boot, a special boot that helps protect your foot and will keep your foot in a constant position.
You will need to stay off of your feet for approximately 2–3 days. At your post surgery follow-up visit which occurs ~2–3 days after the surgery, you will be given the option of keeping your foot in the podiatric boot or switching to a shoe. The shoe is less bulky than the boot and allows a little more movement. You will remain in the boot or shoe for approximately 4–6 weeks.
Some patients may choose to use crutches or a walker following surgery for convenience. However, use of these aides is not required and is not provided by Premier Research.
You may begin doing mild exercise 4–6 weeks following surgery. Mild exercise includes: walking, lifecycle, swimming, elliptical trainer, free weights and weight machine, except those machines that put undue stress on your feet (e.g. leg press). In about 6 weeks you should be about 80–90% recovered.
You should refrain from running or jumping for 3–5 months following the bunionectomy. During your recovery period, you will have regular contact with the podiatric surgeon who will be monitoring your recovery closely and will let you know when you can begin more active exercise.
Back to top
It takes approximately 10–14 days for the bunionectomy incision to heal. During this time you are allowed to bathe/shower, but you must keep the incision area dry. You will be given instructions on how to clean and bandage the incision site to keep the area free from possible infection.
The infection rate of the incision following bunionectomy occurs in approximately 1% of cases. Infection can be avoided by closely following the care instructions provided by the surgeons and research staff.
Back to top
You should call the number on listed on your post-operative instructions in the event that you experience any of the following after you leave the clinic:
- Fever of 101oF (38.3oC) or higher
- Any increased pain that is not relieved by the pain medication prescribed and raising your foot above heart level
- Any unusual side effects that you may be experiencing from the investigational medication you may have received
- Any new or unusual drainage on your dressing
- Any redness, swelling, or drainage from the incision after the dressing is removed
Back to top
The kind of work you do will determine how long you will need to be off of work. If you have a job that allows you to be off your feet most of the day, you may only be out of work for about 1 week. If your job requires you to be on your feet most of the day, you may be required to be out of work a little longer (approx 2–3 weeks).
The surgeon will talk with you about this at the initial visit after evaluating your bunion and will be able to provide you with a more specific estimate as to how long you will need to be out of work.
Back to top
The length of your participation will depend on the study. Typically your participation in a study will last approximately 1 month and will require 4 study visits:
- A screening visit to determine if you are eligible. These visits typically last 2–4 hours.
- The surgery visit is when you will have the surgery to remove your bunion and be randomized to the investigational medication, placebo or active comparator. This visit will require that you remain in the clinic anywhere from 1day/1 night to 5 days/5 nights. The length of the study will be clearly documented in the informed consent form.
- A post-surgery follow-up visit typically occurs 5–9 days after surgery and takes approximately 2–4 hours. At this visit the podiatrist will look to see how well your foot is healing and make sure you are not experiencing any complications from the surgery or from the investigational medication you received.
- A final study follow-up visit typically occurs 30 days after surgery and lasts 1–3 hours. Not all studies require such a visit. The informed consent form will state if such a visit is required and what procedures are done at this visit.
Back to top
Compensation for your time and effort varies by study depending on the number of days/nights involved and the types of procedures done at each study visit. Compensation is based on actual number of visits completed and is approved by the Institutional Review Board. The specifics regarding monetary compensation is included in the informed consent document that you will be asked to sign prior to any study procedures being conducted.
Back to top
All of the study related procedures, medical history and physical exam, the surgery by our board certified podiatrists/surgeons and the investigational medication are provided free of charge. You will be responsible for any prescription pain medication you need once you go home. Typically you are asked to fill the prescription prior to coming in for the surgery so that it is available to you when you leave the clinic. The cost of this prescription is about $50.
Back to top