painful bumps on the side of your foot

The word “bunion” actually comes from the Greek word meaning turnip. They thought that the bump on the inside of the toe that looked red resembled this vegetable, or it could be from the Latin word “bunio” which means enlargement but “turnip” is a more fun idea.  

Depending on the study

10-25% of people have bunions!

If you have a bunion or hallux valgus and you want to discuss the correction options, take the next step toward happy feet and schedule today!

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Bunions Specialist


treatment options

We are asked this question at least once a day.  My response to the question after very careful consideration is to ask the patient “what is your goal?”.

The answer to whether not conservative care can help with bunions depends entirely on their response to that question. If the patient’s goal is to have decreased symptoms and to feel less pain then most of the time conservative care can be somewhat helpful with that.

If the patient’s goal is to have a more visually appealing foot that fits better in shoes and functions more normally without causing ongoing stress at the joint, degenerative arthritis and the associated gait changes  then medical evidence indicates there is little role for conservative care.

In summary conservative care can make you feel better sometimes but it won’t fix the deformity. (You still have the turnip!)   


conservative treatment options



Most small and moderate bunion deformities can be symptomatically improved by discontinuing narrow shoes. A soft athletic type shoe that provides ample room can work great.

Oftentimes women can also purchase men’s shoes because they can be a little bit wider. The problem with this solution is that most women don’t want to wear wide shoes. ”Clunky” is a word I often hear when I suggest this option.

In our clinic, custom orthotics are a great tool to get pressure off the big toe joint.

Orthotics have to be made correctly in order to accomplish this (most are not) but they can really decrease the symptoms in a big toe joint.

At Next Step Foot and Ankle Clinic, we are the first to bring San Antonio and surrounding areas Custom 3D Orthotics with our FitStation by HP(Hewlett Packard), digitized for unparalleled accuracy.

Our FitStation provides thousands of data points on not only the pressure points of your foot standing still (like a cast would) and when your feet are in gait (a person’s manner of walking), giving the doctors a view of how your body as a whole is affecting each foot for your perfectly tailored fit. Helping relieve that pressure off the big toe joint.

Keep in mind, shoes that are narrow don’t work too well with orthotics.  



Using a splint can take a lot of stress off the joint. There are many bunion splints available on the Internet. They can cause a significant improvement in joint pain. Some splints are only made for  nighttime use.

Frequently the daytime splints don’t fit in shoes very well so I just recommend using tape to try and splint the toe in a more rectus position.



Medication for pain or arthritis such as ibuprofen or acetaminophen can help in for awhile and calm down acute pain. Prescription medications can be more effective.



Sometimes in acute painful flares we inject the joint with cortisone  or  other anti inflammatory type substances. This can be a very powerful tool for severe joint pain.



Range of motion exercises, manipulation, ice, heat stretching can help.

Keep in mind the conservative care can do nothing to correct the bunion deformity, it just makes the joint feel better.  

Bunions Specialist

minimially invasive

treatment & surgery

for bunions


treatment & surgery options

Dr. Silvester and Dr. Larsen specialize in many advanced minimally and non-invasive treatments, and if necessaryadvanced minimally invasive and traditional surgical techniques with patient proven success stories.

Some of those are used to treat your bunions, such as:

We are pioneers in minimally invasive surgery (MIS)  for bunions. We were the first in the San Antonio area to perform these procedures.

It is a great option for the right bunion and the right patient but there is a lot of misinformation out there about the procedure. It is not a panacea that makes surgery a magical experience where you can have the surgery and be back in shoes the next day playing golf. Although, it is true that you can sometimes return to shoe gear more rapidly, any time you have a surgery on your foot you do not do yourself any favors by stressing it too early.

In my experience the advantages of minimally invasive bunion surgery are that you have a little less swelling, less scar tissue, generally better range of motion after the surgery. The recovery time is about the same.

No matter what bunionectomy you have if a bone is cut to fix your bunion (which is usually is) it still takes about 6 weeks for that to heal.

All the traditional complications of surgery are still there with MIS bunion surgery. Numbness, infection, loss of position, delayed bone healing or recurrence can all occur. We love minimally invasive surgery in the right circumstance, but keep in mind it works great but it may not be right for you. Luckily, at Next Step Foot & Ankle Clinic our doctors will find what is right for you.

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Don't let painful bunions stop you from living your best life!


Painful bunion
before & after surgery

Slide the arrows left and right to see the incredible before and after success images of this patients severe bunion. 

This patient had a very severe bunion deformity and a very unstable first metatarsal.

This patient required fusion of the first metatarsal cuneiform joint using modern fixation devices which allow early weightbearing, as well as a metatarsal head osteotomy to fully correct her deformity.

This resulted in a complete correction of bunion deformity without the possibility of recurrence. The patient was able to bear weight immediately. She is very happy with the results.

bunion surgery

Tips: A knee scooter makes life more livable. Even though you can usually walk on your foot after bunion surgery you really don’t do yourself any favors using the foot that has had surgery.  A knee scooter allows you to use your hands to do things while not stressing the foot at all!!



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