A woman’s quest to find the perfect shoe can last a lifetime. According to Consumer Reports, the average American woman owns 19 pairs of shoes, purchases at least four pairs a year and doesn’t have enough room to store them all in one place.
For many women, it’s all about fashion, not comfort. Sky-high heels, tight pointy toes and other fashion trends send thousands of women to the podiatrist each year. One of the most common and painful foot problems affecting women is bunions. Bunions are most often caused by wearing shoes that are too tight and squeeze the toes. Bunions also can be caused by heredity, chronic inflammation from arthritis, nerve conditions affecting the feet, congenital deformities and injury.
Bunions form at the base of the big toe when the normal balance of the joints and tendons of the foot become misaligned. The metatarsophalangeal (MTP) joint expands and moves out of place. The big toe bends inward, toward the other toes, and the MTP joint extends outward, toward the other foot. Additional bone and a small fluid-filled sac (a bursa) form at the base of the big toe. The joint eventually becomes inflamed, causing swelling, tenderness and pain. When the bursa becomes inflamed as well, bursitis forms and can lead to additional swelling, redness and even more pain.
In rare cases, a bunion forms at the base of the smallest toe. This “bunionette,” also called a “tailor’s bunion,” can be equally debilitating.
“Surgery can completely correct a bunion,” says podiatrist Joan Carver, DPM, Attending Surgeon, Cooper University Hospital. “It restores the foot back to its normal shape and eliminates the source of pain.”
Dr. Carver recommends surgery when the pain and discomfort have progressed to the point where the patient is in constant pain and the ability to live an active, productive lifestyle is inhibited.
Bunion Symptoms Include
- Development of a firm bump on the outer side of the foot, at the base of the big toe.
- Redness, swelling or pain at or near the MTP joint.
- Corns or other irritations caused by the overlap of the first and second toes.
- Restricted or painful motion of the big toe.
- Inability to wear shoes due to swelling and pain.
According to Dr. Carver, it’s time to see the podiatrist at the first signs of pain and discomfort. When left untreated, bunions get larger and even more painful.
Tips for Temporary Relief of Bunions
The following remedies may help alleviate pain in the early stages of bunion development:
- Apply over-the-counter bunion pads around the MTP joint.
- Tape the MTP joint to keep the joint in its normal position.
- Use ice packs to reduce swelling.
- Take either over-the-counter or prescribed anti-inflammatory medications.
- Stretch the foot.
In some cases, wearing a bunion splint at night can bring some relief. Physical therapy and cortisone shots can also help some sufferers.
What Shoes to Wear With Bunions
It is recommended that people with bunions wear shoes that:
- Conform to the shape of the foot.
- Have a wide and deep toe box.
- Fit the largest foot.
- Have heels less than two inches high.
“We often fit patients with custom-made insoles (orthotics) to put in their shoes,” explains Dr. Carver. “Orthotics help add further support and help reposition the MTP joint.”
It’s Time for Surgery When…
Surgery is the only option when the deformity becomes extreme and the pain does not go away. The operation relieves pressure and repairs the MTP joint. The type of surgery performed depends on the extent of the damage to the foot.
A simple bunionectomy is performed for less severe deformities and involves removing only the bony enlargement. For the most severe bunions, the surgeon typically cuts the bone and repairs the deformed joint and bones by using pins, screws, wires or plates to keep the bones in place.
Surgery is performed on an outpatient basis and only local anesthesia is used. Patients wear a surgical shoe or cast for up to eight weeks. Patients can begin putting weight on the foot two to three weeks after their procedure. Full recovery can take between three and five weeks. Swelling can remain for several months.
To avoid the need for future surgery, patients are strongly encouraged to wear the proper footwear, even if it means giving those Manolo Blahnik’s to a sister, friend or charitable organization.
“We strongly encourage our patients to continue wearing comfortable shoes after surgery,” adds Dr. Carver. “We know how hard it is to resist a great pair of heels, but keeping feet healthy and eliminating the source of pain is our ultimate goal.”