Health Watch by Sherry Mullenix

The North Jefferson News



A bunion is an unnatural, bony hump that forms at the base of the big toe where it attaches to the foot.

Often this condition forces the big toe to deviate toward the other toes. When this occurs, the base of the big toe pushes outward on the bone called the metatarsal bone, which is the bone directly behind the big toe. When this happens, you have what’s called a bunion.

Because the bunion occurs at a joint, when the toe bends in normal walking, your entire body weight rests on the bunion with each step. For this reason, bunions can be very painful.

The big toe is the hardest working toe on the foot. Every time the foot pushes off the ground, this toe supports most of the body’s weight.

Because this toe is so critical to movement, any problems with it can make walking, or even standing, painful. Bunions are one of the most common problems you can experience with the big toe, other than an ingrown toenail.



What causes bunions?

Foot problems typically develop in early adulthood, and get worse as the foot spreads with aging.

For some individuals, bunions “run in the family,” and may be just one of several problems due to weak or poor foot structure. Bunions sometimes develop as a result of arthritis.

Also, fashion can have an effect on bunions. Women are more prone to bunions that men due to years of wearing tight or poorly fitting shoes. Those years of making a fashion statement can gradually push the foot bones into an unnatural shape.



Prevention

Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop, especially if foot problems run in your family.

Exercise your feet and strengthen them. Try picking up light small items with your toes, like a pencil or pebble. Wear shoes that fit, and don’t cramp or pinch your toes. Women should avoid high heels and pointed toe shoes.

Bunions can be treated symptomatically at home. That includes taking medications you can buy without a prescription to relieve the toe pain. These medications do not prevent or cure the bunion, but may relieve the pain and inflammation.

Normal daily activities can be done with reduced discomfort. It also helps to wear shoes that don’t hurt your feet. For example, avoid high heels or narrow shoes with pointed toes. Wear pads to cushion the bunion, or you can purchase custom-made shoe inserts.

It’s important to realize that in some cases, proper fitting shoes could have prevented the bunion in the first place. Avoid activities that put excessive pressure on your big toe or feet. Try swimming or bicycling instead of jogging for exercise. Surgery may be an option for more severe cases.

A visit to the physician or podiatrist for a complete evaluation is necessary prior to surgery. The doctor will most likely ask questions about past health.

Questions he or she might ask are: When did the bunion start? What activities make it worse? Do any other joints hurt?

The doctor will examine the feet and toes for range of motion and alignment. This most likely will be done while sitting, again while standing, and most likely observed as you are requested to walk as they observe your foot motion and toe movement.

The physician will also take an x-ray of the foot to rule out other conditions, as well as to evaluate the internal bone structure of your foot. The x-rays are good usually for six months while the patient decides if this is the option he/she wants to follow.

Surgery is usually done in an out-patient setting. It often takes less than an hour. In most cases, a general anesthetic is given for the procedure. Recovery time can vary from the type of surgery the physician feels will best relieve your condition.

One type of surgery can be a shifting of the soft tissue to realign the affected joint and then shaving the bone. The most common bunion surgery is shifting the bone, which reduces the angle between the first and second toes to realign the big toe, and the bunion is shaved off.

When the bunion is severe, a piece of the bone may be removed from the metatarsal bone, and the big toe realigned, and held in place with a pin or screw.

The physician will prescribe a period having the foot elevated, rest, and ice pack along with pain medications for a short time after the procedure. Also, a surgical shoe is usually worn in the recovery phase.

The doctor will want to have the patient come in for a check-up in a few days. Total healing time can vary from a week to more than a month depending on the extent of the procedure performed.

Surgical correction of a bunion can reduce the pain, and improve the appearance of the foot.

I’ll let you know the outcome as I underwent this procedure last week. Recovery so far has been tolerable, but not without some discomfort.

Shopping for shoes without a bunion will make life a little easier.

Sherry Mullenix (J.D., R.N.) co-owns The Pharmacy in Mount Olive with her husband, Steve Mullenix (R.Ph). They can be reached at 631-1201.