TOApril Leonard likes to blame her husband for her bunions. In 2017, she accompanied him to a podiatrist appointment for calluses and he went home with surgery scheduled to correct his misaligned finger bone.
In retrospect, it was a good thing. “He told me, ‘I really wish you would do this now, because it’s not going to get better,’” Leonard, 56, recalls of that unexpected first conversation with the doctor. He had painful bunions on both feet and had begun to have trouble performing daily tasks on his farm in Missouri. Besides, he didn’t like the way they looked. “When he went to the pool or the beach and looked at my feet, it was like, yuck,” she says. Then, in 2017, Leonard underwent a lapiplasty bunion correction procedure on his left foot; four years later, he had it on his right foot.
More than 25% of people Bunions occur all over the world, and this deformity, which is especially common among older people, is more likely to affect women than men. But it would not be known to what extent common alliances are based on the level of the discourse that surrounds them; They’re not exactly considered dinner conversation. That should change, experts say. “It’s not talked about much… but it’s an insecurity that patients have,” says Dr. Dana Brems, a specialist in podiatric foot and ankle surgery in Los Angeles. “People say they feel uncomfortable wearing open-toe shoes or sandals because of the appearance of the bunion.” More discussion about bunions, including how they affect quality of life and what to do about them, could help alleviate that stigma, he adds.
A genetic predisposition
If you have a bunion, the first metatarsal bone, which is just behind the big toe, will gradually shift toward the other foot. “It’s not resting directly on the midfoot bone. “He’s a little lazy and leaning to one side,” says Dr. Ebonie Vincent, an Irvine, Calif., podiatrist and star of My feet are killing me in affection. Visually, she will notice a lump at the base of her big toe and will probably feel pain there, especially while exercising or wearing narrow shoes. You may notice swelling or redness around your big toe, develop calluses or calluses, and have limited movement of your toe.
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Bunions are usually caused by a genetic predisposition, says Vincent, who sees them in patients at least a few times a day. Most people who suffer from them report that their mother, grandmother, or great-grandmother also had them. Some are progressive, becoming larger (and more painful) over time, especially with strenuous activity or as a result of stuffing your feet into ill-fitting shoes. However, not all sufferers will experience pain. “There are people who have lived and died very happily in unions,” Vincent says. In those cases, they are little more than a cosmetic nuisance. But for others, they can make life much more annoying.
Unpleasant complications
When new patients come to Dr. Geoffrey Phillips’ office, they often focus on the appearance of their foot, but the orthopedic surgeon at Northwell Health in Great Neck, New York, is more concerned about its function. “We look at the profile or, as I like to say, the personality of the foot,” he says. “We like to make sure patients have happy feet – feet that function well and have no associated pain.”
That includes determining whether a bunion causes harmful side effects. Once people have a symptomatic bunion, Phillips says, there is a “pretty high frequency” of other problems affecting the foot. Some patients, for example, will develop osteoarthritis over time as a result of an untreated bunion. Others may experience nerve inflammation. Many have problems with the adjacent fingers and develop a hammertoe (in which the finger has an abnormal curvature at the middle joint) or a crossed toe. “The second finger starts crossing over the first,” says Phillips. “Basically, you have a crossover, and the first drifts toward the second, and the second drifts toward the first.” When this happens, surgery is usually required to return the finger to its normal position.
How to find relief
The main reason people go to the doctor about their bunion is because they are in pain, Phillips says. Some may make lifestyle modifications that eliminate the need for surgery, especially if they begin while the bunion is still in its early stages. Phillips’ first recommendation is to make changes to your footwear. “If they’re used to wearing high heels, we try to change that reliance on more balanced footwear,” she says. “That may include shoes with a wide toe box, so there is less pressure on the foot.” It may also be helpful to look for “rocker sole shoes,” which have a curved sole that smoothes the transition from heel strike to landing on the forefoot.
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When considering footwear, look for a comfortable pair with good cushioning and a fit; You don’t want your feet to get caught or slip, says Phillips. If you need to wear leather or dress shoes, ask a shoemaker to stretch them: “They have machines that can stretch the toe box so there’s more room for your toes,” he says. Custom orthotics, which are inserts based on scans of the foot, may also be helpful.
People with bunions are often drawn to quick fixes on the Internet, such as toe slings and bunion splints. Some purchase toe spacers, which are placed between the toes to reduce pressure on the joint. “They will relieve pain as long as you wear it,” says Vincent. “You’re not fixing anything. “You’re putting your bones in a more aligned position so they work better while you walk.” When you remove the toe spacer or take off the sling, your bunion will still be there, as painful as ever.
Podiatrists do not typically operate on bunions for cosmetic reasons alone, but bunion correction surgery is the gold standard treatment for people who experience ongoing pain and find it difficult to walk. There are several types of surgery, most of which involve cutting and repositioning the bone at the base of the big toe. Lapiplasty, the procedure Leonard had in Missouri, is a newer technique approved by the U.S. Food and Drug Administration in 2016. In addition to returning the bone to its normal alignment, the unstable foot joint is secured with titanium plates.
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People can usually walk right after surgery, but they must wear a special shoe after surgery, such as a boot, for at least a few weeks. “That’s just inevitable: Solid bone takes six to eight weeks to heal,” Brem says. “You’ll probably be back to full activity after about three months, running and jumping and that kind of stuff.”
Five months after Leonard had his left bunion removed, he ran a 10K race. After a year, he was running half marathons again. He now no longer feels pain and he happily wears running shoes, mud boots and cowboy boots on the farm. “It’s been a really good thing; I wish I’d done it sooner,” he says. “It is not a debilitating surgery. “I can understand why people wait longer to do it, but six weeks (of recovery) is nothing compared to the rest of your life.”