More than half of Americans are walking around with bunions. These troublesome bumps develop when your weight falls unevenly on the tendons and joints, distorting the foot and causing a hard knob to form next to the big toe.
Tight shoes and high heels are the traditional suspects. But the fact that so many people have bunions— including women who never wear high heels and men who prefer loose, comfortable footwear— points to other causes. The shape of the foot, congenital deformities, or inflammatory disease such as rheumatoid arthritis may play a role. Bunions can also develop as a result of trauma (injury) to the foot.
That said, you can increase your risk of having bunions with the wrong type of footwear. High heeled shoes force the weight forward and jam the toes into the box. In fact, any type of ill-footing shoes, or standing for long periods of time— especially while carrying extra weight— sets you up for bunions.
Women’s feet tend to relax during pregnancy, growing longer and wider. New moms might need to reassess their old footwear. It’s possible that Mommy (not Baby, as the old gambler’s chant says) needs new shoes.
Surgery is the only way to completely eliminate a bunion, but there are treatments that can reduce pain and discomfort. Silicon gel pads or shoe inserts may help. Stretching, splints or massage are other options.
Surgery For Painful Feet
When you come in to the clinic (any of our locations in DeSoto, Dallas or Sunnyvale), we will examine your feet and ask you about your daily activities, your footwear, and the level of pain you are experiencing. Bunion therapy is based on the discomfort factor. If the bunion is interferring with your ability to walk, stand or wear shoes, we will consider more aggressive treatment. If it’s a minor inconvenience, we’ll help you cope, using one or more of various conservative options.
The type of surgery depends on the individual’s situation. For some patients, it’s enough to shave the bone so it doesn’t rub against the inner shoe. More serious cases may be treated with bone relignment, and stabilization with pins and screws. A new surgical treatment, called a tightrope, fastens a wire to the bone and pulls it into place. This treatment, which was developed by a surgeon at Midwest Orthopaedics at Rush, in Chicago, is being evaluated for long-term results.
The tightrope (or mini-tightrope) involves drilling four tiny holes through the bone, and passing ultra-thin wire through the openings. The wire is pulled to bring the first metatarsal bone inward, aligning the big toe. The wire is anchored by a tiny button. Proponents say the patient can be walking unassisted in six to eight weeks.
While surgery is not the first recommendation for most patients, 85 to 90% of patients who have had bunion surgery report dramatic relief of pain and re-alignment of the big toe for a more comfortable gait.
Bunions: If the Shoe Fits, Wear It
Bunion surgery does not give you permission to wear smaller shoes or narrow, pointed footwear. In fact, post-surgical patients are asked to choose their footwear carefully. If a patient resumes wearing shoes that caused a problem in the first place, the bunion could reappear.
Success depends on both surgeon and patient. It’s important to follow the doctor’s instructions after the operation. Patients are discharged with bandages, braces or other supports to hold the foot in place. You may be advised to use a walker, cane or crutches for a few days.
Physical therapy can help restore the strength and range of motion to your foot. You may also be prescribed an antibiotic to prevent infection.
The most important factor in a successful outcome is the relationship between doctor and patient. If you find a doctor you trust, with whom you have good communication, you’re halfway home to solving the bunion problem.