You may have noticed that podiatrists aren’t big fans of the kinds of shoes some people go crazy for: pointy toes, heels that hit above the knees…you get the picture. However, the reason for this is not that your podiatrist has some evil plan to make you as unfashionable as possible. It is simply that the shoes considered fashionable are often the very shoes that can seriously aggravate numerous foot problems.
Take bunions. Now, bunions aren’t actually caused by wearing ill-fitting shoes, but they make an already difficult problem worse. Bunions are actually caused by congenital misalignments in the foot. These inherent structural problems with the foot will put more stress than usual on the joint where the big toe connects to the first metatarsal (the long bone that attaches to the big toe and runs the length of the middle of the foot). Eventually, this stress can cause the tissues around the joint to stretch and become less resilient, leading to further misalignment of the bones. Eventually, the metatarsal begins to stick out toward the inner edge of your foot, and the big toe begins to point toward the others. This often results in a bump on the inside edge of your foot right next to your big toe.
The issue that many of you may be most interested in is that bunions can make it difficult or even impossible to wear shoes. The truth is, shoes that don’t fit properly are often the things that turn bunions from juvenile delinquents into real delinquents. Shoes with tight toes or pointed heels can put even more stress on an already stressed toe joint, further exacerbating foot misalignment. The good news is that sometimes giving up those pointy, high-heeled shoes can make your bunion problem much easier to bear.
The only way to permanently correct a bunion is through surgery. However, there are things you can do to get out of pain.
1) Get rid of those darn high heels and pointy shoes. Oh really. The best shoes, especially for people with bunion problems, have a toe box (the toe box at the bottom of the shoe) that accommodates all of your toes (not just the ones fashion says you should have) and allows them to move. a bit.
2) Avoid heels that are higher than an inch or two (the lower the better). For some people (though not all), this may be all they need to do to get rid of the pain associated with bunions. However, many people will find that they need more extensive treatment.
3) Sometimes placing felt or over-the-counter bunion pads on the bunion will reduce pressure on the bunion and provide considerable relief.
4) Bandaging your foot (you can ask your podiatrist how to do it correctly) can also help keep things in proper alignment, thus reducing stress on the joint.
5) You can reduce the inflammation associated with bunions by applying ice for twenty minutes per hour (always use a thin towel between the ice and the skin), or by using anti-inflammatory medications such as ibuprofen. (Your podiatrist may occasionally prescribe a stronger oral or injected anti-inflammatory medication.)
6) Some people also find that physical therapy (specifically ultrasound therapy) can reduce bunion pain.
7) If deemed necessary by your podiatrist, orthotics can be used to try to correct the original misalignment that caused the problem and thus prevent the bunion from getting worse.
Unfortunately, sometimes the above treatments don’t correct the problem enough to allow you to live without significant pain. If that’s the case, then it may be time to discuss surgical options with your podiatrist.
