Gloria May, M.S., R.N., CHES | Jun 9, 2012, 1:39 a.m.
Bunions (those swollen, painful bumps on the inside of the foot at the base of the big toe) are so closely associated in our minds with women and with fashionable but often ill-fitting shoes, that the question I was asked last week as to whether or not men even get bunions was not at all unreasonable.
While it’s true that ninety percent of bunions occur in women and that more than fifty percent of women in America have them, gender and shoe choice are not entirely to blame. Yes, men do get bunions, but children can also develop bunions and even folks who live in mostly shoeless societies have bunions, so there’s obviously more to bunions than just womens’ ill-fitting shoes.
In medical lingo, a bunion is a Hallux Valgus. It’s an enlargement of the bone or the tissue around the base of the big toe which in turn pushes the big toe out of alignment and causes it to slant towards the second toe.
The underlying cause of bunions, according to Dr. Zachary Chattler of Johns Hopkins University, is the foot’s genetic structure and how it causes us to walk. Bunions do run in families but it is the foot type we inherit (low arches for example) that causes the foot to turn outward (“pronate”) when we walk that encourages the formation of bunions; we do not inherit the bunions themselves.
However, shoe choice does play a large role. Narrow, pointed toe, sky-high heels can cause a bunion to develop more quickly and even play a role in its recurrence after surgery.
How do you know if your shoes fit properly? Seems many folks believe that their feet haven’t grown since their teen years (Is that similar to the belief that our belt sizes haven’t changed?) but in truth, as our foot ligaments loosen and our arches flatten over time, our feet do get bigger.
One source I read suggests that in order to tell if you are buying the correct size shoe, you should stand barefoot on paper, have a friend trace the outline of your feet, and then place your shoes on top of each outline to see if your foot is wider than the shoe. The idea seems reasonable given that we no longer (thankfully) have those shoe fit x-ray machines prevalent in shoe stores in the fifties. Remember those?
If you have bunions, you may require surgery but there are solutions to try first:
• Make sure your shoes are the right size.
• Ask your doctor if either over-the-counter or custom-made orthotics, inserts that prevent your feet from “over-pronating” are for you.
• Consider taking an anti-inflammatory medication such as ibuprofen but ask how much you can safely take in one day.
• Inquire if steroid injections might help with the pain.
• Stick to low-impact exercises (walking, swimming) as they are kinder on your feet.
If surgery is your only option, there are a number of procedures available to correct the misaligned joint and remove the bump. Bunion surgery (bunionectomy) is usually done on an outpatient basis, but understand that healing can take months and yes, bunions can come back, especially if you just cannot resist those Manolo Blahniks.
This article appeared in the June 2012 issue of Northwest Prime Time, the Puget Sound region’s monthly publication celebrating life after 50.