Johns Hopkins Health Alert
Bunion Basics
Many people are plagued by pain from bunions, a deformity that forces the big toe out of alignment. But it's not a lost cause -- there are ways to relieve the pain.
The primary cause of bunions is your foot's structure, explains podiatrist Zachary L. Chattler, D. P. M., an instructor in the Department of Orthopaedic Surgery at Johns Hopkins. According to Dr. Chattler, bunions occur most frequently in feet that pronate -- meaning, as a person walks, the ankle rotates internally and the forefoot rotates externally. Bunions may result from this pronation, which causes an abnormal pull on the foot's tendons and bones.
But heredity isn't completely to blame; shoe choice does play a considerable role. Narrow or poorly fitting shoes, like high heels, can exacerbate bunions by pushing toes into an abnormal position and putting pressure on toe joints.
"That's why women seek treatment for bunions far more frequently than men, even though both genders develop the deformity. Shoes won't cause a bunion, but they can speed up the progress and make it worse," says Dr. Chattler. People with rheumatoid arthritis also may develop bunions, because of inflammation and swelling in the toes.
Simple solutions can soothe bunion pain.
- Make sure your shoes fit properly. Trade in narrow, flat shoes or high heels for shoes with wider toe boxes and more support, like sneakers.
- Are your shoes the correct size? Dr. Chattler stresses that many adults think their feet haven't grown since their teens; in truth, feet continue to get bigger as the ligaments loosen and arches flatten over time.
- Orthotics can help. In addition to changing footwear, your doctor might also prescribe custom-made orthotics that fit in shoes and prevent the foot from overpronating. Some insurance plans may cover custom orthotics, which usually cost $300–500; however, Medicare does not.
- Medications. To relieve pain and swelling, nonsteroidal anti-inflammatory drugs like ibuprofen are recommended. A steroid injection also may be prescribed.
For further short-term relief, podiatrist Bruce S. Lebowitz, D. P. M, an instructor in t he Department of Orthopaedic Surgery at Johns Hopkins, suggests keeping feet elevated and sticking to low-impact exercises like walking, water aerobics, or stationary biking, which will not aggravate the bunion as much as running or other high-impact activities.
Although bunions are permanent, most people find relief through conservative treatments. If not, surgery may be the next option. Many surgical procedures can correct the misaligned joint and remove the bump.
Surgery usually lasts about one hour with local anesthesia, and most patients leave the hospital that day. But healing can take eight to 12 weeks, and swelling can last up to six months. Although surgery will relieve bunion pain, bunions can grow back, especially if you continue to wear ill-fitting shoes. So choose the right footwear to stay pain free.
Posted in Healthy Living on July 15, 2009
Reviewed January 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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