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December 10, 2010 | Comments: 0

Foot Notes: Bunions

Many women develop bunions, which can be painful and unsightly. A severe one can make it hard to walk. Here’s how to cope.

The conventional wisdom used to be that women bring bunions on themselves by wearing high heels, tight shoes, and other uncomfortable foot gear, but other factors are now known to be more important in causing bunions. These include slightly abnormal foot structure, flat feet, and overpronation (your foot rolls inward as it hits the ground). The fault, it seems, is not so much in our shoes as in our genes. If your grandmother and mother have (or had) a bunion, you are more likely to have one. Even people who habitually go barefoot get bunions.

Also known as hallux valgus, a bunion is a deformed big-toe joint with a bony outgrowth at the end of the metatarsal bone at the base of the toe. The big toe angles toward the second toe, or even over it or under it. Corns may develop on the second and third toes, and calluses on the ball of the foot. The toe joint may also show signs of arthritis.

What do

If you have a bunion, see your physician and/or a podiatrist for an exam. This will probably involve a foot X-ray. To get relief from bunion pain, try simple methods first:

• Get a shoe with a wider toe box. Avoid high heels or any shoe with a pointy toe. If your shoe is basically okay but just a little tight, a shoe repair shop may be able to stretch it. A podiatrist can give practical advice about new shoes.

• If you overpronate, you may need orthotics—insoles designed to correct such problems. A podiatrist can advise you and can fit you with customized orthotics, though often ready-made insoles from the drugstore may serve the purpose. Some inserts come with a toe separator that pushes the big toe away.

• Bunion-relief gel pads that fit over the toe may reduce discomfort and are sold in most drugstores.

The surgical option

If pain from a bunion persists and you have trouble walking or exercising, consider surgery. There are many kinds of bunions and a variety of surgical procedures. About 200,000 people have bunion surgery in the U.S. every year. Studies here and in Sweden have shown that surgery is generally successful—that is, most people have less pain (after several weeks of recovery) and are glad they went ahead with it. But if you have other disorders, particularly diabetes, or are in poor health, bunion surgery may not be a good option. Get a second opinion before proceeding, and look for a podiatrist or orthopedic surgeon with experience in this kind of surgery.

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