The vast majority of people considering bunion surgery are women, and of those most have a history of wearing high heels and shoes with a narrow toe box. A narrow toe box is a very pointed toe on a shoe, which combined with the forward weight on the ball of the feet causes the big toe to push inward and over the other toes.
The need for bunion surgery occurs because this pushing over of the big toe causes the joint of that toe to push out, creating a large swollen area on the side of the foot just under the big toe. The joint is no longer straight but protrudes out to the side of the foot, causing pain when pressed against shoes or when weight is on the joint in the course of a normal stride.
Progressive in Nature
While there is some genetic component to bunions, and conditions like arthritis can also contribute to the problem, they are all progressive in nature and develop over time. Wearing high heels sparingly or even when standing or walking for limited amounts of time will not typically cause the condition.
However, wearing high-heeled, pointed shoes, or shoes that are too small for long periods of time while standing or walking, or wearing these shoes on a daily basis, is much more likely to result in bunions. They tend to start small and become more of an issue with inflammation. When untreated, they can become more deforming and change the bone and joint structure, requiring bunion surgery.
Options Other than Bunion Surgery
At the first signs of swelling of the big toe, or ideally even with a slight irritation of the toes, changing shoes to a wide toe box that allows toes to sit flat and straight is the best option. Choosing soft leather or canvas shoes, or going with open-toed sandals without a strap across the top of the toe area can also be an option.
Even with a mild bunion, simply changing shoes can be enough to provide healing and relieve the pressure and pain. This should also include seeing a podiatrist and having your feet measured for shoes that fit correctly.
There are special orthotics that can provide soft, comforting layer around the big toe, and to help keep the foot snug into the shoe footbed. This can also be beneficial in helping to straighten the big toe over time. Splints may be worn at night to hold the toe straight, slowly reversing the structural damage and helping to keep the toe pain-free.
While these options will work with mild to moderate bunions, for serious pain and significant deformity of the joint, bunion surgery may be the only option. Talk to your orthopaedic surgeon and consider your options; you may have more than you think.
If you are considering bunion surgery, see our orthopaedic surgeons before making a final decision. To learn more about Suburban Orthopaedics visit us online at www.suburbanortho.com.
