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Foot Care
When You Have a BunionTake measures to relieve the pain—and get out of those pointy shoes! 
Before and after bunion surgeryTop photo shows the extremely angled big toe associated with a painful bunion. After surgery (bottom photo), the first metatarsal bone has been cut and the toe realigned. “Bunions do run in families,” says podiatrist Scott Lipkin, D.P.M., of Lehigh Valley Hospital and Health Network. “The foot shape you inherit can make you more susceptible.” What exactly is a bunion? “It is a deformity of your big toe joint—an internal callus or thickening that forms on the metatarsal bone,” says orthopedic surgeon George Arangio, M.D., of Lehigh Valley Hospital and Health Network. In a normal foot, the big toe extends out straight or very slightly angled from the bone below. With a bunion, that joint becomes sharply angled as the big toe points inward and the lower bone outward—and it pushes painfully against your shoe. If you have a bunion, it almost certainly stems from that pointy-toed, high-heeled footwear you’re so fond of. “Bunions are far more prevalent in women than men,” Lipkin says. A pointed shoe squeezes your toes together, and high heels add stress by tipping weight forward onto the toes. The first step to ease the pain is switching to the most comfortable shoes you can find. “You also can apply ice, take ibuprofen, and use a cushioning pad or arch support,” Lipkin says. “Orthotics (custom shoe inserts) and steroid injections may help.” If your bunion is so painful it interferes with walking and other activities, you may need surgery. Only about 20 percent of bunions fall into this category, Arangio says. The surgeon removes the bunion and often cuts and realigns the bones. Bunion surgery, he notes, is not a cosmetic procedure. Depending on how extensive it is, you’ll be off your foot for up to a week, on crutches or surgical shoes for four weeks and limited to athletic-type shoes for another several weeks. The best course is prevention. It’s important to wear low-heeled shoes that fit properly, Arangio says, especially if your big toe angles naturally or you have flat feet. Both those characteristics raise your risk for bunions.
Want to Know More about bunions, foot health or choosing a shoe that fits well? Click here or call 610-402-CARE. Footnote For DiabeticsEven if your bunion isn’t painful, see a doctor about it. Diabetes affects your circulation, which makes any foot problem a special concern. This page last updated 2/12/08 04:08 PM
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