Bunions. Just the word is repelling and scary. Sadly, bunions are an ugly, yet all-too-common foot deformity that afflicts millions of American women. And some men.
The incidence of bunions has risen over the years to the point where it has become practically an epidemic. Especially among women who spend hours on their feet such as nurses, teachers and waitresses, many of whom are also runners.
Somewhat surprisingly, running doesn’t actually cause a bunion. Many incorrectly assume that running is a primary cause, possibly because wearing the wrong running shoes can exacerbate an already painful condition.
First, a bunion is usually initially described as a sharp, angular bump on the side or base of the big toe. Initially, there may not be any pain, but over time the bump swells to the point it becomes an unsightly and painful problem that can be so debilitating (especially for older women) that it requires surgery.
Bunions are a progressive disorder that begins with a leaning of the big toe. Over time, the angle of the metatarsal bones change and can point one way while forcing the big toe to point another way and/or overlap the other toes. When this occurs, the toes of the foot (most commonly, the second toe) are forced sideways. Instead of pointing forward, the toes are angled.
The base of the big toe also often gets larger and sticks out. The bones are thrown out of alignment and gradually produces the characteristic bump on the side which becomes more and more prominent.
The bigger the bunion gets, the more it hurts to walk or run. The joint flexes with every painful step and over time, the bunion continues to worsen and enlarge, making walking or running extremely difficult.
Sadly, bunions have become so common that more than half of all American women suffer from them. Many women, and the relatively few men who are hobbled by bunions, assume that years of wearing shoes that were too tight is the primary culprit.
Although wearing tight, narrow shoes can make bunions worse, the actual cause is usually something that’s inherited. Most often, an inherent faulty foot structure is the cause. Typically, flat feet. That’s why you’ll see entire generations of women suffering from bunions that have been passed on from child to child. Blame your parents.
Young girls may develop adolescent bunions that they can thank their mothers for. Usually though, young girls can move the toe without undue pain. Make sure your daughter is wearing shoes with a wide toe area that don’t irritate the bunion.
How do you know if your ball-of-foot pain is actually caused by a bunion? The appearance of the bunion on the large toe is usually quite distinctive, but this will also be accompanied by foot pain, tenderness as well as a red discoloration of the skin overlying the bone. It isn’t pretty. Sometimes there is a burning sensation or even numbness of the toes or foot.
A podiatrist may want to take x-rays to help determine the degree of the deformity and assess whether surgery is indicated.
Bunions won’t just go away with the typical home remedies of rest, anti-inflammatories and ice. Usually they get worse over time, but ice and rest can calm the pain and discomfort.
Even though it won’t just disappear, most cases of bunions are treatable without resorting to surgery.
Here’s what you can do before making any decision on surgery:
1. Change your shoes. Wearing the right kind of running shoe with a wide toebox is critically important. Many podiatrist recommend wide running shoes—even for their patients who don’t run. If you do run, look for stable, firm running shoes with a wide toe area. New Balance shoes are offered in numerous widths as well as most other brands that offer a wider width.
2. Toss any high heel shoes into the garbage. You can also include any dress shoes with pointy toes in the dumpster. You won’t be able to wear them ever again.
3. Pad it. Inexpensive bunion pads can be bought at any drug store. Merely place them over the area of the bunion to reduce friction and pain.
4. Toe spacer. A pad that goes between the first and second toe may help shift the big toe back to a less painful position.
5. If possible, avoid standing for long periods of time. In fact, get off your feet as much as possible. Take frequent breaks to get off your feet. When home, use ice or frozen vegetables to relieve the inflammation.
6. Medicate. Over-the-counter anti-inflammatories may help a little. Try Aleve, Advil or Ascriptin for pain relief.
7. Give your feet a break. Whenever possible, take your shoes off and walk around barefoot.
8. Orthotics. Corrective foot devices–orthotics–may be prescribed by your podiatrist to relieve the pain.
If the bunion has progressed to the point where the pain isn’t reversible or there is difficulty walking, surgery may be the only option. Bunion surgery realigns bones, ligaments, tendons and nerves so the big toe can be brought back to a correct position. Usually, surgery is done on an out-patient status, but the recovery time is long (several) months and can be quite frustrating because the bunion can come back.