You may have noticed Podiatrists are not big fans of the kinds of shoes that some people go nuts over: sharply pointed toes, heels that come up higher than the knees… you get the picture. However, the reason for this is not that your podiatrist has an evil plan to make you as unfashionable as possible. It is simply that the shoes considered fashionable are often the same shoes that can seriously aggravate numerous foot problems.
Take bunions. Now, bunions aren’t actually caused by wearing poorly-fitting shoes, but they do make an already tough problem much worse. Bunions are actually caused because of inborn misalignments within the foot. These inherent structural problems with the foot will place more stress than usual on the joint where the big toe connects with the 1st metatarsal (the long bone that attaches to the big toe and stretches down the length of the middle of the foot). Eventually, this stress may cause the tissues around the joint to stretch and become less supportive, thereby leading to further misalignment of the bones. Eventually, the metatarsal starts jutting towards the inside edge of your foot, and the big toe begins to point toward the other ones. This often results in a bump on the inside edge of your foot right next to the big toe.
The problem many of you may be most interested in is that bunions may make it difficult or even impossible to wear shoes. The truth is that ill-fitting shoes are often the things that turn bunions from juvenile delinquents into outright criminals. Shoes with tight toes, or pointed heels, may put even more stress on an already stressed-out toe joint, further aggravating the misalignment of the foot. The good news is that sometimes giving up those pointy, high-heeled shoes may make your bunion problem much easier to bear.
The only way to correct a bunion permanently is through surgery. There are things that you can do, however, to get yourself out of pain.
1) Get rid of the darn high-heels and pointy-toe shoes. Seriously. The best shoes, especially for people with bunion problems, have toe boxes (the space for toes at the end of your shoe) that accommodate all of your toes (not just the ones fashion says you should have), and enable them to move around a bit.
2) Avoid heels that are higher than an inch or two (the lower the better). For some people (although not everyone), this may be all you need to do to rid yourself of the pain associated with bunions. However, many people will find that they need more extensive treatment.
3) Sometimes putting felt or over-the-counter bunion pads on your bunion will reduce the pressure on the prominence and provide considerable relief.
4) Taping the foot (you can ask your podiatrist how to do this properly) may also help hold things in proper alignment, thus reducing the stress on your joint.
5) You can reduce the inflammation associated with bunions by applying ice for twenty minutes an hour (always use a thin towel between ice and your skin), or by using anti-inflammatory medications such as ibuprofen. (Your podiatrist may occasionally prescribe a more potent anti-inflammatory oral or injected medication.)
6) Some people also find that physical therapy (specifically ultrasound therapy) may reduce bunion pain.
7) If your podiatrist deems it necessary, orthotics may be used to try to correct the original misalignment that caused the problem and thus prevent the bunion from worsening.
Unfortunately, sometimes the above treatments don’t correct the problem enough to enable you to live without significant pain. If that’s the case, then it may be time to discuss surgical options with your podiatrist.