The Truth About Bunions and How They Affect Your Feet
What’s an article on bunions doing in a series about joint health? We already know what you’re thinking, “Surely, bunions are a skin problem?” Actually, that’s not true!
Unfortunately, that sore bulge sticking out of the side of your shoe isn’t just any old bump. It’s actually a joint problem, which can lead to other related foot problems as well. Sunway Medical Centre’s podiatrist, Lim Yuanshuang reveals the straight facts about bunions.
Toe-ing The Line
Bunions are actually caused by the deviation of the big toe which occurs when pressure — such as from tight shoes — is applied to the side of the big toe. This can cause the big toe to move inwards towards the other toes (see image 1).
“The ligament connecting the metatarsal and phalanx (see image 1) loosens so it doesn’t do its job anymore. Then, the fluid sac and cartilage in the joint between the metatarsal and phalange starts to get damaged and inflamed which causes pain,” explains Lim.
She adds that the bones in the foot will eventually restructure and the muscles in the foot will continue to pull in the wrong direction. Over time, the sesamoid bones (found under the first metatarsal and helps the flexor tendon bend the big toe downwards) may also deviate because the first metatarsal moves away from its original position.
No Sole Cause
According to Lim, bunions are more common among women and obese men. “Rock climbers and cyclists are prone to bunions as well. This could be because of their footwear.” Restrictive footwear, especially in ladies’ footwear, places more pressure on the foot which tends to contribute to the formation of a bunion.
Genetics play a part as well. Some people are more predisposed to getting bunions. Ligament laxity or ‘loose ligaments’ which is caused by genetics and constant pressure on the toes can cause an individual to easily develop bunions.
Getting Off On the Wrong Foot
“Most of our weight is supported by our big toe when we walk.” Lim explains that when our body weight is not transferred properly, the weight will shift onto the second toe. Calluses may form on the ball of the foot below the second to the fourth toe.
Other foot problems that start with a bunion include arthritis of the big toe joint, altered gait, discomfort when wearing narrow shoes that may apply pressure to the joint and pain when moving the joint. Bursitis (inflammation of the bursa) on the top of the first metatarsal may also occur and cause pain.
A Step in The Right Direction
A general practitioner can identify a bunion just by looking at it. However, if the bunion is severe and causes pain during movement, a visit to a podiatrist is a must. Lim explains that a podiatrist can assess patients by looking at their feet, gait and also their footwear. A podiatrist will also advise the patient on what to do next. This could include surgery or adjustments to the types of shoes they wear. Sometimes, a simple lifestyle shift can improve the symptoms.
“X-rays are only necessary in order to rule out cases of gout or rheumatoid arthritis. It also depends on the severity of the bunion…the angle of the toe’s deviation,” says Lim. Anything more than 15 degrees between the first and second metatarsals (see image 1) would be considered abnormal. Deviations of more than 35 degrees would be considered a severe bunion.
It is advisable, especially for women, to choose flat footwear rather than high heels. This is because high heels restrict movement of the feet. When in high heels, a woman’s feet are also ‘forced’ to support her entire body weight in an unhealthy and unnatural manner. If doing away with high heels isn’t an option, check out our tips in Positive Steps for Aching Tootsies that will make wearing high heels a wee bit more comfortable for your toes.
Getting Back on Your Feet
When it comes to bunion surgery, the aim is to realign the joint, relieve pain and correct any deformities. “Surgery is the only method that can restructure the foot back to its normal state,” explains Lim. If surgery is not something you’re comfortable with, you can consider orthotics, which are commonly known as shoe inserts such as gelled toe spacers, bunion splints, bunion cushions and much more. These can help relieve pain caused by pressure on the bunion.
However, see a podiatrist to get shoe inserts that are perfectly tailored to your needs. No two feet are made the same and a podiatrist can make minor adjustments based on the condition of your feet, in order to alleviate your symptoms.
Positive Steps to Help Aching Tootsies
- If possible, do away with pointy-toed high heels. They crush your toes together which can aggravate an existing bunion. Go for heels with a toe box that has a similar shape to your feet.
- Make sure that your high heels fit properly. Ensure that your heel doesn’t slip out or that your feet don’t slide to the front.
- A thicker heel is more stable. It gives you better balance and can help relieve pressure by distributing the weight throughout the foot.
- If you do have a bunion and need to wear restrictive shoes, get bunion pads to cushion your bunion and alleviate pain.
A Bunion, a Corn or a Callus?
Here are Lim’s expert insights on bunions, calluses and corns
|Bunions (See image 1)||Calluses (See image 2)||Corns (See image 3)|
|Quite obvious because of the angle of the bone||Hard pieces of skin usually found on the balls of the feet||Harder pieces of skin that can grow underneath calluses but can also present by itself such as in image 3|
|Gets worse without treatment||Easily rectified by podiatrist||Can be slightly more complicated than a callus if the corn has grown very deep or large|
|Shoe inserts can alleviate symptoms||Can be removed with a blade by a podiatrists, painlessly and without bleeding||Can be removed with a blade by podiatrists painlessly and without bleeding|
|Requires surgery to correct the joints||Should try to remove calluses to prevent corns||Will keep growing deeper if not removed and cause pain if it reaches the vascular level|