AApril Leonard likes to blame her husband for her bunions. In 2017, she accompanied him to an appointment with a podiatrist to treat calluses — and came home scheduled for surgery to correct the misaligned toe bone.
In retrospect, it was a good thing. “He said, ‘I really wish you would do this now, because it’s not going to get better,’” Leonard, 56, recalls of that unexpected first conversation with the doctor. She had painful bunions on both feet and began having difficulty managing daily tasks on her Missouri farm. Plus, she didn’t like the way they looked. “When I would go to the pool or the beach and look at my feet, it was like, ew,” she says. Then, in 2017, Leonard had a lapiplasty bunion correction procedure on her left foot; four years later, she had her right foot.
More than 25% of people All over the world have bunions – and the deformity, which is particularly prevalent among the elderly, is more likely to affect women than men. But you wouldn’t know how common bunions are based on the level of discourse surrounding them; they don’t exactly qualify as dinner conversation. That must change, experts say. “It’s not talked about much… but it’s an insecurity that patients have,” says Dr. Dana Brems, a specialist in podiatric foot and ankle surgery in Los Angeles. “People say they feel uncomfortable wearing open shoes or sandals because of the appearance of the bunion.” More discussion about bunions, including how they affect quality of life and what to do about them, could help alleviate that stigma, she adds.
A genetic predisposition
If you have a bunion, the first metatarsal bone – which is just behind the big toe – will gradually move sideways towards the other foot. “It’s not sitting directly on the midfoot bone. It’s being kind of lazy and leaning to one side,” says Dr. Ebonie Vincent, a podiatrist in Irvine, Calif., and star of My feet are killing me on TLC. Visually, you’ll notice a bulge at the base of your big toe—and you’ll probably feel pain there, especially during exercise or if you wear narrow shoes. You may notice swelling or redness around your big toe, develop corns or calluses, and find that you have limited toe movement.
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Bunions are typically caused by a genetic predisposition, says Vincent, who sees them in patients at least a few times a day. Most people who have them report that their mother, grandmother, or great-grandmother also had them. Some are progressive and become larger – and more painful – over time, especially with intense activity or as a result of wearing ill-fitting shoes. Not everyone who has them, however, will experience pain. “There are people who lived and died with bunions very happily,” says Vincent. In these cases, they are little more than a cosmetic nuisance. But for others, they can make life much more annoying.
Unpleasant complications
When new patients come to Dr. Geoffrey Phillips’ office, they often focus on how their foot looks — but the orthopedic surgeon at Northwell Health in Great Neck, NY, is more concerned with how it’s functioning. “We look at the profile, or as I like to say, the personality of the foot,” he says. “We like to make sure patients have happy feet: feet that function well and have no associated pain.”
This includes finding out if a bunion is causing harmful side effects. When people have a symptomatic bunion, Phillips says, there is a “fairly high frequency” of other problems involving the foot. Some patients, for example, will develop osteoarthritis over time as a result of an untreated bunion. Others may experience swollen nerves. Many have problems with adjacent toes and develop a hammer toe – in which the toe has an abnormal curvature at the middle joint – or a crossed toe. “The second toe starts to cross the first,” says Phillips. “You essentially have an intersection, and you have the first one deflecting into the second, and the second deflecting into the first.” When this happens, surgery is usually required to return the toe to its normal position.
How to find relief
The main reason people go to the doctor for a bunion is because they are experiencing pain, says Phillips. Some may be able to make lifestyle modifications that eliminate the need for surgery, especially if they start when the bunion is still in its early stages. Phillips’ first recommendation is to make changes to your shoes. “If they are used to wearing high heels, we try to change that dependence to more balanced shoes,” he says. “This could include shoes with a wide toe box so there is less pressure on the foot.” It may also be helpful to look for “rocker bottom shoes,” which have a curved sole that softens the transition from heel strike to landing on the forefoot.
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When thinking about shoes, look for a comfortable pair with good cushioning and that fits; you don’t want your feet to get caught or slipping around, says Phillips. If you need to wear leather or dress shoes, ask a shoemaker to stretch them: “They have machines that stretch the toe box so there’s more room for your toes,” he says. Custom orthotics, which are insertions based on foot exams, may also be helpful.
People with bunions are often attracted to quick fixes on the Internet, such as bunion slings and splints. Some purchase toe spacers, which are placed between the toes to reduce pressure on the joint. “They will ease the pain while you are using them,” says Vincent. “You’re not fixing anything. You are putting your bones in a more aligned position so they function better as you walk.” When you remove the toe spacer or take off the sling, your bunion will still be there – as painful as ever.
Podiatrists don’t usually operate on bunions just for cosmetic reasons, but bunion correction surgery is the ideal treatment for people who experience ongoing pain and have difficulty walking. There are several types of surgery, most of which involve cutting and repositioning the bone at the base of the big toe. Lapiplasty — the procedure Leonard performed in Missouri — is a newer technique approved by the U.S. Food and Drug Administration in 2016. In addition to returning the bone to its normal alignment, the unstable foot joint is fixed with titanium plates.
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People can usually walk immediately after surgery, but they need to wear special post-surgical footwear, such as a boot, for at least a few weeks. “This is inevitable – solid bone takes six to eight weeks to heal,” says Brem. “You’ll probably be back to full activity after about three months, running and jumping and that sort of thing.”
Five months after Leonard had her left bunion removed, she ran a 10K race. Within a year, she was running half marathons again. Now, she is pain-free and happily wears running shoes, dirt boots, and cowboy boots around the farm. “It’s been a really good thing – I wish I had done it sooner,” she says. “It’s not debilitating surgery. I understand why people wait longer to do this, but six weeks [of recovery] It’s nothing compared to the rest of your life.”
This story originally appeared on Time.com read the full story
