Bunion (Hallux Valgus) Surgery: Can Virtual Reality Help Calm Nerves and Reduce Pain?

Bunion surgery can feel daunting, even when we know it’s the right step to relieve pain and improve mobility. Preoperative jitters are common—and they matter. Anxiety can influence how we experience postoperative pain and even the medications we might need. A recent study offers an intriguing twist: could a brief virtual reality (VR) hypnosis session before bunion (hallux valgus) surgery meaningfully ease anxiety and reduce stronger painkiller use afterwards?

What the Study Looked At

In a prospective, randomised, single-centre study, researchers assessed adults scheduled for percutaneous bunion (hallux valgus) surgery who had significant preoperative anxiety (STAI score > 40). Sixty patients were randomised into two groups: one received a preoperative VR-based hypnosis session, and the other did not.

• Population: 60 adults with high preoperative anxiety
• Intervention: Preoperative hypnosis via VR mask
• Control: Standard care without VR
• Outcome measures: Anxiety (postoperative and predischarge) and use of higher-level analgesics immediately after surgery

Reference: Foot & Ankle International (2023), Level II prospective cohort study. PMID: 37118916 | DOI: 10.1177/10711007231162816

Key Findings at a Glance

• Postoperative anxiety modestly improved with VR: mean 42.5 vs 45.2 (P < .04)
• Predischarge anxiety was lower with VR: mean 25.3 vs 30.2 (P < .03)
• Fewer patients needed stronger analgesics (e.g., morphine or ketamine) immediately after surgery with VR: 3.3% vs 26.6% (P < .03)

In practical terms, a short VR hypnosis session before bunion surgery was associated with calmer patients and less frequent use of high-potency pain relief in the immediate postoperative period.

Why Anxiety Matters in Bunion (Hallux Valgus) Surgery

We often see a direct relationship between preoperative anxiety and perceived pain after surgery. When anxiety is reduced, patients may experience smoother recoveries—fewer spikes in pain, less reliance on strong opioids, and an easier transition to home. For hallux valgus patients, especially those undergoing day-case percutaneous procedures, this can make the difference between a comfortable recovery and a rocky first 24–48 hours.

How Virtual Reality Hypnosis Fits Into Modern Perioperative Care

VR-guided hypnosis is designed to immerse patients in calming, structured scenarios that help focus attention, reduce distress, and prime the brain for a more relaxed surgical experience. It’s non-invasive, quick to deliver, and can be integrated alongside standard anaesthesia and multimodal analgesia.

In this study, the benefits were modest but clinically meaningful: lower anxiety scores and reduced immediate need for potent analgesics. From a clinician’s perspective, that aligns with broader efforts to minimise opioid exposure, support day-case recovery, and improve patient satisfaction.

What This Means If You’re Considering Bunion (Hallux Valgus) Surgery

If you’re anxious before surgery, you’re not alone—and your care team should take it seriously. Tools such as VR hypnosis may complement standard approaches like clear education, reassurance, regional anaesthesia techniques, and non-opioid analgesics.

1. Ask about preoperative anxiety screening (e.g., STAI) if you feel particularly nervous.
2. Discuss non-pharmacological options like VR hypnosis, relaxation breathing, or guided imagery.
3. Plan a multimodal pain strategy to reduce reliance on opioids where possible.

Limitations and Perspective

The study was single-centre with a relatively small sample size, and focused on adults with higher baseline anxiety undergoing percutaneous bunion surgery. Results may not generalise to all patients or techniques. Still, the signal is encouraging: VR hypnosis appears to be a safe, low-burden addition to perioperative care with measurable benefits.

Expert Take: A Small Step With Tangible Upsides

From our vantage point in foot and ankle surgery, small gains in comfort and reduced opioid exposure are worth pursuing—particularly when the intervention is simple and well-tolerated. VR hypnosis won’t replace good anaesthesia, surgical technique, or thorough rehabilitation, but it can be a useful adjunct for patients who feel anxious before bunion (hallux valgus) surgery.

Bottom Line on Bunion (Hallux Valgus) Surgery and VR

For adults with significant preoperative anxiety, a brief VR hypnosis session before bunion (hallux valgus) surgery modestly reduced postoperative and predischarge anxiety and cut immediate use of higher-level analgesics. It’s a promising tool to personalise care and make recovery a touch easier. For further details, see the study in Foot & Ankle International: PMID 37118916 and DOI 10.1177/10711007231162816.

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