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Several treatment methods are available for a painful little toe aka bunionette. Most people will try to avoid surgery, and they will use non-surgical methods which often provide pain relief. In more severe cases, surgery might be the only solution.

Painful Little Toe: Surgery Vs Non-surgical Treatment

Should you choose a surgical approach or home treatment for a painful bunionette? That is a question a lot of patients and doctors face, but the answer is not always simple. Surgery is the only choice for patients who already tried all non-surgical treatments without success, and their doctors estimate that, beyond any doubt, only a surgical correction can help. The line between the two approaches is not always clear, and those "borderline" patients can choose what will be their next move for bunionette pain relief.

Non-Surgical (Home) Treatment For Bunionettes

If the bunionette doesn’t hurt, the non-surgical approach is the right one. Even if it hurts, it may be the right one. A number of orthotics are available on the market designed to help with bunionette pain relief at home and treat painful little toe. Those products can slow down the development of a bunionette as well, so all patients that have this condition should use them to delay or even prevent a surgical treatment [1]. 

What Can You Expect From Non-Surgical Bunionette Treatment?

The treatment of all bunionettes starts with non-surgical options.

The results are encouraging. The vast majority of patients get good therapeutic results by just using orthotics and changing their habits that can worsen the condition:

  • wearing high heels with a narrow toe box,
  • avoiding usage of orthotics, etc. [2].

Even if the condition is painful, the non-surgical approach can relieve the pain completely and prevent further development of a bunionette. It’s hard to estimate the non-surgical treatment success rate since a lot of patients treat their bunionette on their own without even asking for medical help.

The rough estimate would be that more than 90 percent of patients will put the situation under control and resolve the pain with non-surgical treatment. 

What Are The Pros Of Home Treatment For Bunionettes?

The most significant advantage of non-surgical treatment is that it doesn’t have contraindications. Another important aspect is that it does not disable a patient for a month (or even longer) as the surgical treatment does. 

Although surgery can provide bunionette pain relief, patients have to continue with post-surgery exercises and a treatment routine even after successful correction of a bunionette. Post-surgery routine is another reason to stick to a non-surgical treatment as long as possible. All surgical procedures (anesthesia as well!) carry their risks, so if the benefit to risk ratio is not beyond any doubt, in favor of surgical treatment, a person should avoid the operating room for as long as possible. 

What Are The Cons Of Bunionette Home Treatment?

From a medical point of view, there are no cons to non-surgical treatment. On the other hand, the pain frustrates patients a lot and sometimes it is hard to maintain motivation for the non-surgical routine (it seems like the more you try to relieve the pain, the more it hurts) [3]. It can take some time and effort to resolve the issue with pain, and once a patient learns how to take care of a painful bunionette, things become easier to handle.  

Surgical Bunionette Treatment 

As mentioned above, the surgical correction of a painful bunionette is considered a last resort solution. The good thing about it is its efficacy  — more than 90 percent of patients will describe the result of the operation as satisfactory or very satisfactory [4]. Keep in mind that surgical correction is not a definitive solution; the foot is “as good as new” and recurrence of pain can happen if the patient does continue the non-surgical routine after the surgery. The most common surgical procedures are the variations of the osteotomy fixation [5].

What Can You Expect From Surgery?

After a recovery period of six to eight weeks, the pain will go away. As a matter of fact, the pain will get a lot better in the first two weeks after the surgery. The surgery won’t necessarily fix the esthetics of your foot. Bony prominence will appear a lot smaller, but the slight disfiguration of a foot will remain pretty much the same. Some patients are particularly sensitive about the esthetical appearance of the bunionette. The procedure is not meant to be an esthetical reconstruction, but a functional reconstruction of a foot. 

What Are The Pros Of Surgery?

  • The pain is gone, or the pain is significantly lower in intensity!
  • Also, the bunionette callus tends to heal after the surgical correction since there is no more mechanical pressure of the bony prominence to the skin above it.
  • The quality of life slowly goes back to normal, and patients feel a lot better than before (as mentioned above, pain, no matter its reason, can tremendously lower your quality of life).

What Are The Cons Of Surgery?

The main cons of a surgery are complications:

  • intraoperative,
  • early post-operative,
  • and late post-operative complications.

Although rarely, some patients develop the condition again to a certain extent.

Another drawback is a recovery period. It takes approximately two weeks to go back to driving a car (pushing a foot brake too early in the recovery period will open a whole new world of pain for a patient with a bunionette) and 6-8 weeks to fully recover and this prolonged healing period can be a problem for the working population.

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