Bunions – Fort Myers Podiatrist Separates Fact From Fiction
Simply wearing tight shoes does not necessarily cause the formation of bunions. Many individuals could spend a lifetime pulling off that svelte slender-footed look and never once find their style hampered by a bunion. Indeed, they may develop a number of other foot problems from their cramped footwear but a bunion wouldn’t be the cause of their misfortune.
The cause of bunions actually lay beneath the skin and is associated with a prominence along the outer edge of the first metatarsal where it meets the hallux, or big toe. This prominence is known as a hallux valgus, which literally refers to an abnormal angulation of the big toe. As a passing inspection would reveal, the hallux valgus is a clear deformity of the big toe, displacing the first metatarsal outward from the midline of the foot and often angling the proximal phalange – the hallux – back in toward the four other toes. In other words, this forms a large, boney bump along the side of the foot that is known more popularly as a bunion.
The propensity to develop bunions is largely genetic. Though the actual hallux valgus deformation may not be passed down from one generation to another, the potential for it to occur is. This potential is found in the genetic traits that make up foot shape as certain feet are more prone to bunion formation than others. Flat feet are a common leading factor along while exceptionally flexible ligaments and irregular bone structure also contribute to bunion development. It is those who possess these bunion-prone feet that have to be wary of tight-fitting shoes or high-heels that place considerable stress on the wearer’s toes as it takes far less to shift their metatarsals out of alignment than it does those less prone to bunions.
Due to the types of fashionable footwear that place the most pressure and stress upon the wearer’s feet – and those particularly precarious first metatarsals – women have a greater tendency to develop bunions than men. One in three women in the United States have bunions and, of all accumulated bunions recorded, nine out of ten have occurred in women subjects. Additionally, and perhaps relevantly, ballet dancers, owing to the shape of their slippers and the stresses placed on their toes, tend to be especially prone to bunion formation.
Besides the most common type of bunion forming along the first metatarsal there also exists a number of variations on a theme of bunion formation. A so-called “tailor’s bunion” (also known as a bunionette) can develop on the opposite side of the foot, associated with the fifth metatarsal and little toe. Named in reference to a tailor’s tendency of sitting cross-legged while working, with pressure placed on the fifth metatarsal, this bunion is more likely to affect individuals who wear shoes that are too narrow for their feet. Additionally, bunions can form due to inflammation of the joints associated with rheumatoid arthritis, neuromuscular disorders, bone fractures, physical abnormalities, and certain birth defects.
A notable effect of bunion formation arises from the boney projection rubbing along the inside of one’s footwear. This can result in painful irritation and the development of a fluid-filled sac known as a bursa along the affected area. Everyone has an array of beneficial bursas scattered throughout their bodies, namely in the elbows and knees. These provide important cushioning that helps to reduce friction in these joints. The bursa that forms with a bunion also helps to cushion the joint that it is located near (in the case of a standard bunion it is the first metatarsophalangeal joint) but can also be painful in itself and restrict movement due to its swelling. This discomfort may prevent an individual from wearing footwear of any kind and could restrict their ability to even walk due to intense pain.
Bunions should be treated by a foot specialist as soon as possible. And there are a number of approaches that can be taken in relieving the pain and fixing the hallux valgus.
Simply adopting looser and more comfortable shoes can make a difference. Athletic shoes, for example, are typically less restrictive and allow plenty of room for the foot, with extra room for the toes and the capacity to add padding and insoles if desired. Custom-made insoles, known as orthotics, can also be fit comfortably within these shoes to provide support. If heels must be worn then a height of no greater than two inches is recommended. Properly sized shoes, worn each day, will allow one the option of wearing less foot-friendly shoes on the occasions when dressier footwear becomes a necessity.
A podiatrist may also choose to tape the joint affected by the bunion in order to reduce its movement and thereby stop the anomaly from worsening. Toe spacers made out of gel or a combination of bunion splints and cushions may also be used. The application of ice packs and compression bandages can help reduce the swelling and anti-inflammatories can also be used. Corticosteroid injections, as an example, are a common anti-inflammatory that can be delivered directly into the affected area to provide direct relief.
If left unattended the bunion could continue to worsen resulting with more swelling and increased pain, perhaps even turning a shade of blue. The hallux valgus may even continue to spread increasingly outward with the phalange angling increasingly inward to the point where it comes into contact with its neighboring toe. In extreme cases the affected toe actually turns inward so far that it forces itself beneath the toe beside it. In cases such as these, surgery may be the only available option.
There are several types of surgery available to a podiatrist for removal of a bunion, each one dependent upon the severity of the anomaly. The surgery might merely involve removing the abnormal bony protrusion along the first metatarsal to physically realigning and straightening the displaced metatarsal or phalange to be even with its neighbors. More serious cases mean more invasive procedures like realigning cartilage and repositioning the small sesamoid bones beside the first metatarsal to going as far as shortening, lengthening, raising, or lowering the metatarsal. It may even be necessary to stabilize the bones using screws and internal splints. No matter the sort of surgery, recovery time often lasts from six to eight weeks and requires the patient to use crutches and refrain from activities that place stress upon their feet.
Bunions are generally easily avoided, even for those who have feet predisposed to bunion formation, by the use of comfortable, loose shoes that do not place unnatural stresses upon the foot. This may not always prohibit their formation and, in the event that one is stricken with hallux valgus development, they should make an appointment with a podiatrist immediately to treat the anomaly as soon as possible to prevent complications and irreversible damage.
And for anyone with even the start of a bunion, and happening to live in North Fort Myers – really anywhere along the Gulf Coast from about Sarasota to Naples – you should definitely make an appointment with Dr. Joseph Campbell and Dr. Brad Habadua, the premiere bunion specialists along Florida’s Gulf Coast.