A common question in my practice is when should I have my bunion fixed? After a full evaluation of the foot including an x-ray, I can determine the proper alignment of the great toe joint. In conjunction with x-rays, a physical and biomechanical exam is performed to ascertain what has caused the bunion. I mean, you didn't arrive into the world with them, right? Most commonly, the predisposing factor is pronation. Excessive arch collapse. This unlocks the foot and makes it more flexible. Over time, you develop deviation of the great toe. This is improper alignment. This mal-alignment can lead to progressive degeneration of the great toe joint and cartilage loss.
A bunion is a progressive deformity and will lead to arthritic changes within the joint and cause lasting deformity. Most often times, this effects the ability to wear some shoes.
I recommend having your bunion evaluated radiographically and biomechanically. In the early stages, it's as simple as a prescription orthotic device. More severe cases will necessitate a surgical re-alignment of the joint.
So when it the best time to have your bunion evaluated and fixed? When you first notice the big toe encroaching upon the second digit and a bump on the inside of your foot. Early intervention is the key to a life long healthy great toe joint.