Bunion surgery recovery time: a week-by-week timeline

Bunion surgery recovery at a glance

A bunion (hallux valgus) is a bony bump at the base of the big toe that forms as the big toe drifts toward the other toes. Bunion surgery straightens the joint, usually by cutting and shifting a bone or by fusing a joint, and then holding it in place with screws or a small plate while it heals.

These are typical timelines. Your surgeon’s instructions come first, because they’re based on the exact procedure you had.

Why recovery depends on the type of bunion surgery

There are many bunion procedures. The biggest difference for recovery is whether the surgeon cuts and shifts a bone (an osteotomy) or fuses a joint (an arthrodesis). Fused bones generally need more protection while they heal.

Surgeons often add a small bone cut in the big toe itself (an Akin osteotomy) to straighten it further. This doesn’t usually change the recovery much.

Minimally invasive bunion surgery uses a few small cuts instead of one larger one. It may mean smaller scars and possibly less early swelling, but the bone still takes about the same time to heal, so the overall timeline is similar.

Bunion surgery recovery week by week

Days 1 to 3: the hardest part

• The numbing nerve block often wears off 12 to 24 hours after surgery. Take your pain medicine as directed before it wears off, not after the pain arrives.
• Keep your foot raised above the level of your heart almost all the time. Some surgeons ask for 50 to 55 minutes of every hour. Stack pillows under your calf, not just your heel.
• Ice, if your surgeon recommends it, goes over the dressing or behind the knee for 15 to 20 minutes at a time. Keep the dressing dry.
• Get up only for the bathroom and meals, using the crutches, walker or knee scooter you were given, and wearing the surgical shoe or boot.
• Move your other leg and wiggle your toes, and pump your ankles if allowed, to help prevent blood clots. Your surgeon may also prescribe a blood thinner.

These are usually the worst days. Pain should ease noticeably by the end of the first week.

Days 4 to 14: resting and protecting

• Keep the dressing on, clean and dry until your first follow-up visit, usually 1 to 2 weeks after surgery.
• Short walks around the house in the surgical shoe or boot, as your surgeon allows. More walking now means more swelling.
• Many people can switch to over-the-counter pain relievers during this time.
• At around 2 weeks, the stitches come out and your surgeon may take an X-ray to check the position of the bone.

Weeks 2 to 6: more walking, still protected

• Showering: once the incision has closed and your surgeon agrees, you can usually wash the foot normally. Don’t soak it in a bath, pool or hot tub until you’re told it’s fully healed.
• Walking: gradually more, still in the surgical shoe or boot. Swelling will be worse at the end of the day. That’s normal.
• Toe exercises: your surgeon may start you on gentle big toe movement to prevent stiffness. Some people wear a toe spacer or splint to hold the toe’s position.
• Keep raising your foot when you’re sitting, especially in the evening.

Weeks 6 to 8: out of the surgical shoe

• A follow-up X-ray checks that the bone is healing. If it is, you’ll usually move into a wide, soft sneaker. After a fusion, this step may come later.
• Your foot will still swell. You may need a wider shoe, or a half size larger, for a while.
• Physical therapy often starts or steps up now, to work on the big toe’s movement, your walking pattern, strength and balance.
• Many people who had surgery on the right foot can start driving again around now.

Months 3 to 6: back to most activities

• Most daily activities and most jobs are back to normal.
• Low-impact exercise first, then running, jumping and sports from about 3 months, building up gradually with your surgeon’s agreement.
• Swelling still comes and goes, especially after a long day or in hot weather.

Months 6 to 12: full recovery

• Swelling settles, and more of your shoes will fit.
• Numbness or tingling around the scar usually improves, although a small patch can stay numb.
• The foot keeps getting stronger and more comfortable for up to a year.

How to manage pain and swelling after bunion surgery

• Take pain medicine as your surgeon prescribed. Opioid pain medicine is usually needed for only a few days. It can cause constipation, so drink plenty of water.
• Ask before taking anti-inflammatory pain relievers such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Some surgeons recommend them; others ask you to avoid them after a fusion because they may slow bone healing. Don’t take them if you have kidney disease, stomach ulcers or take a blood thinner, unless your doctor says it’s safe.
• Raise your foot above your heart. It’s the main way to control swelling in the first 2 weeks.
• Use ice carefully, over the dressing or behind the knee, never directly on skin, and not at all if your surgeon advises against it. Your foot may be numb from the nerve block, so you can’t rely on it to tell you it’s too cold.
• Try a compression sock later on, once the incision has healed and your surgeon agrees. See our guide to compression socks for swelling.

Walking after bunion surgery

For many bone-cut procedures, you’ll be allowed to walk short distances in a surgical shoe from the first day or two, putting weight mainly on your heel. The stiff sole keeps pressure off the big toe while the bone heals.

After a Lapidus fusion, you may need to keep weight off the foot completely at first, using crutches, a walker or a knee scooter. Follow your surgeon’s weight-bearing instructions exactly: walking on the front of the foot too soon can shift the bone before it heals.

Most people walk without the surgical shoe or boot at around 6 to 8 weeks. A slight limp for a few weeks after that is common, and physical therapy helps.

Shoes after bunion surgery

• Weeks 0 to 6 or 8: the surgical shoe or boot your surgeon gave you.
• From about 6 to 8 weeks: a wide, deep, soft sneaker with a roomy toe box, laced loosely. Sandals with adjustable straps can work in warm weather if your surgeon agrees.
• From 3 to 6 months: most everyday shoes that are wide enough at the toes.
• From about 6 months: dress shoes or low heels for short periods. Narrow, pointed shoes and high heels press on the joint, so many surgeons suggest keeping them for occasional use.

Driving and going back to work

Driving:

• Left foot surgery, automatic car: often within 1 to 2 weeks, once you’re off opioid pain medicine and can get in and out of the car safely.
• Right foot surgery: wait until you’re out of the boot or surgical shoe and can press the brake hard, as in an emergency stop, without pain. That’s often around 6 to 8 weeks.
• Never drive while taking opioid pain medicine. Check with your surgeon, and your car insurer if you’re unsure.

Work:

• Desk job: often 1 to 2 weeks, if you can keep your foot raised. Working from home may be possible sooner.
• Job on your feet: usually 6 to 8 weeks.
• Heavy physical work: often 3 months or more.

Physical therapy and exercises after bunion surgery

Some people recover well with a home program, and others do better with a physical therapist, especially if the big toe is stiff or walking still feels awkward at 6 to 8 weeks. Do exercises only once your surgeon has cleared them. Common ones include:

1. Ankle pumps and circles, from the first days, to help circulation.
2. Big toe range of motion: gently bending the big toe up and down with your hand, then on its own.
3. Towel scrunches and marble pickups to strengthen the small muscles of the foot.
4. Calf stretches against a wall.
5. Heel raises and balance work later on, as the bone heals.

A stationary bike, with the pedal under your heel at first, and swimming, once the incision has healed, are good ways to stay active. Gentle scar massage, once the incision is fully closed, helps it soften.

Evolve Health offers post-surgical rehabilitation with licensed physical therapists at select Florida offices. Our guide to foot and ankle physical therapy explains what to expect.

Possible complications and when to call

Most people recover without problems, but know the warning signs.

Call 911 if you have:

• chest pain, sudden shortness of breath or coughing up blood, which can mean a blood clot has traveled to the lungs

Call your surgeon the same day if you have:

• pain, swelling, warmth or redness in your calf or leg (a possible blood clot)
• a fever over 101°F (38.3°C), or chills
• redness spreading around the incision, pus, a bad smell, or the incision opening up
• pain that gets worse instead of better, or isn’t controlled by your medicine
• toes that turn cold, pale or blue, or new numbness after the nerve block should have worn off
• a dressing that feels too tight or is soaked with blood

Mention it at your next visit if you notice:

• a big toe that stays very stiff
• screws you can feel that rub or hurt
• pain under the ball of your foot (see our guide to ball of foot pain)
• the big toe drifting back toward the other toes, or pointing inward

Other possible problems include a bone that is slow to heal, which is more likely if you smoke, and the bunion coming back over time.

What helps you heal well

• Follow the weight-bearing rules exactly, even when your foot feels better.
• Don’t smoke or use nicotine. It slows bone and wound healing.
• Keep blood sugar in range if you have diabetes.
• Eat enough protein, and get enough calcium and vitamin D.
• Do your exercises and keep your follow-up appointments, including the X-rays.

Thinking about bunion surgery?

Surgery is usually for bunions that hurt and limit what you can do despite wider shoes, padding and other care, not for looks alone. If you’re wondering why you have bunions in the first place, see are bunions hereditary?

An Evolve Health podiatrist can examine your foot, take X-rays on site with digital X-ray, explain whether surgery makes sense and which procedure fits your bunion, and talk through the recovery for that procedure. Learn more about bunion and hammertoe correction, or find a podiatrist near you and book online.