Bunion (Hallux Valgus) Surgery: Can Virtual Reality Ease Pre-Op Nerves and Post-Op Pain?

Considering bunion (hallux valgus) surgery and feeling jittery about the day itself? You’re not alone. Anxiety before an operation can nudge up pain afterwards and slow recovery—so anything that safely calms nerves is worth a closer look. A recent study explored whether a simple intervention—using a virtual reality (VR) “hypnosis” mask pre-operatively—could ease anxiety and reduce the need for stronger painkillers after bunion surgery. The findings are modest yet meaningful, and they add to a growing body of evidence that mind–body strategies can improve surgical experiences.

What Did the Study Examine?

Researchers evaluated adults scheduled for outpatient percutaneous bunion (hallux valgus) surgery who had significant preoperative anxiety, defined by a State-Trait Anxiety Inventory (STAI) score above 40. Sixty patients were randomised into two groups: one received a preoperative VR-based hypnosis session; the other did not. Anxiety was measured postoperatively and before discharge, and the team tracked the use of higher-level analgesics (such as morphine or ketamine) immediately after surgery. Full details are available via the abstract on PubMed and the journal DOI 10.1177/10711007231162816.

Key Results at a Glance

Among anxious patients undergoing percutaneous bunion surgery, the VR session produced these outcomes:

• Lower postoperative anxiety scores compared with controls (42.5 vs 45.2; P < .04)
• Lower predischarge anxiety (25.3 vs 30.2; P < .03)
• Reduced need for immediate higher-level analgesics (3.3% vs 26.6%; P < .03)

In plain terms, a short VR-based hypnosis experience before theatre modestly reduced anxiety and made stronger painkillers less likely right after surgery.

Why This Matters for Bunion (Hallux Valgus) Surgery

Bunion correction—particularly percutaneous techniques—has advanced, with smaller incisions and more predictable recovery. Yet, patient experience hinges not just on surgical precision but also on how we manage fear and discomfort around the operation. High pre-op anxiety can heighten pain perception and increase postoperative analgesia needs. The study suggests a practical, non-pharmacological tool that complements standard care without adding risk.

Fast Answers for Those Short on Time

1. Does VR reduce anxiety in bunion surgery? Yes—modestly, both after the operation and before discharge, in patients already identified as anxious.
2. Does it cut down on strong painkillers? Yes—patients using VR were less likely to need immediate opioids or ketamine post-op.
3. Is it a replacement for anaesthesia or analgesia? No—it’s an adjunct to enhance comfort and potentially reduce medication needs.

How Does VR “Hypnosis” Help?

VR can provide immersive distraction, guided relaxation, and reframing of sensations—mechanisms similar to clinical hypnosis and cognitive behavioural strategies. By engaging visual and auditory pathways, it may dial down the body’s stress response, which in turn can ease pain intensity and anxiety. While the effect size here was modest, even small reductions can matter when combined with modern multimodal analgesia.

What This Means for Patients at Liv Harley Street Hospital

We often use a layered approach to comfort: clear pre-op education, regional anaesthesia where appropriate, careful surgical technique, and personalised pain plans. Adding an evidence-informed tool like VR for patients with higher anxiety could slot neatly into that pathway. It’s non-invasive, quick, and—importantly—patient-centred.

Strengths and Caveats

• Prospective, randomised, single-centre design focused on a defined anxious population.
• Outcomes are practical: anxiety scores at meaningful time points and immediate analgesic use.
• Limitations include modest sample size (n=60), single-centre generalisability, and focus on short-term endpoints; longer-term pain and function were not reported.

Where Does This Fit in the Bigger Picture?

Non-pharmacological anxiety reduction strategies—VR, guided imagery, prehabilitation education—are increasingly part of perioperative care. While more large-scale studies are needed, this research aligns with the broader shift towards enhanced recovery: optimise the mind and the body follows. For bunion (hallux valgus) surgery, where early mobilisation and comfort are priorities, even incremental gains can smooth the journey home.

Practical Takeaways for People Considering Bunion (Hallux Valgus) Surgery

• If you’re prone to pre-op nerves, ask about VR relaxation or guided hypnosis as part of your preparation.
• Combine mind–body strategies with your surgeon’s pain plan—good sleep, breathing techniques, and a realistic recovery roadmap.
• Expect VR to complement, not replace, local anaesthesia, oral analgesics, and standard postoperative care.

The Bottom Line

In adults with significant preoperative anxiety undergoing percutaneous bunion (hallux valgus) surgery, a brief VR “hypnosis” session modestly reduced anxiety and lowered the immediate need for stronger painkillers. It’s not a silver bullet, but it’s a promising, low-risk add-on that fits well within modern, patient-centred surgical care. For those of us helping patients through bunion surgery, it’s another practical tool to make the day smoother and the recovery a touch easier. Explore the study via PubMed or the DOI 10.1177/10711007231162816.

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