Bunion Myths, Misconceptions, and Treatments: 10 Things You’ve Always Wanted to Know To Treat Your Feet
Posted by Jenn F. on Thursday, November 6th, 2014
Every podiatry practice has its list of specialties. At The Center for Podiatric Care and Sports Medicine, bunions are one of our specialties. We find many people come in feeling ashamed, embarrassed, and nervous about their bunions due to common misconceptions. However, bunions are nothing to be ashamed or embarrassed of, and can often be treated without surgery. Here are ten things you need to know about bunions that may put your mind at ease, clear up a few mysteries, and give you a more realistic perception of your treatment options.
1. Yes, young people get bunions, too.
The old lady with a bunion is seared in our imaginations, but bunions can actually develop much earlier and become quite pronounced by the teenage years. Many people do not seek treatment for their bunions until the joint becomes stiff and arthritic, causing problems with mobility. If you notice a bunion in your 20s or 30s, it’s wise to seek counsel and have regular x-rays done because it is possible to slow or stop the progression.
2. Bunions are a misalignment.
People often think that a bunion is a deformed or overgrown bone. In reality, the first metatarsal bone shifts outward to create the prominence at the joint. Poorly fitted shoes can exacerbate bunions, but we believe there is a genetic component to the development of a bunion as well. Genetically tight calves or arch instability can cause instability and overload on the bones of the feet. While there isn’t much you can do about that, there are actions you can take to slow the progression and reduce the symptoms associated with a bunion.
3. Surgery is not the first option.
Our podiatrists have a list of minimally invasive treatment options we run through before surgery is discussed. From time to time, we do receive a new patient who has been to see other podiatrists, who is at their wit’s end and has “tried it all.” If you have been suffering from a chronic bunion that has caused you pain and aggravation for quite some time, we can talk about whether you’d be a good candidate for surgery or not.
4. Surgery can be done under local anesthesia.
The notion of being “put under” for surgery can be daunting. In medical terms, there is a big difference–in terms of cost and liability–for going under the knife under general versus local anesthesia. Many bunion surgeries are outpatient procedures using only local anesthesia. However, if you have a hard time mentally coping with the surgery, you may elect to be asleep for the whole time.
5. There are two main types of bunion surgery.
While there are dozens of techniques and procedures, there are two main types of bunion surgery. Osteotomy involves cutting and removing part of the toe bone. Arthrodesis involves fusing two big toe bones together. Studies show there are few overall differences in complication rates or functional outcomes, but we consider many different factors–including age, activity level, and foot structure–when deciding which type of procedure is best for you.
6. Successful bunion surgery is not 100% guaranteed.
About 85% of bunion surgeries do cure pain and straighten the toe. The success of the surgery depends upon the severity of the bunion, the type of procedure selected, how well the surgery goes, and your ability to adhere to recovery guidelines.
7. Bunions are not just an issue of vanity.
Despite what insurance companies would lead you to believe, not all bunions are a “cosmetic” issue. Some minor protrusions do not cause a lot of issues, but we see patients who suffer tremendous chronic bunion pain, arch loss, deviation of the toes, and calf pain. Diabetics with neuropathy are at higher risk of developing ulcers and foot infections if the bunion rubs against the shoe.
8. Childbirth is a common cause of bunions.
We’ve seen patients who have worn a size 9 for their entire lives suddenly shift to a size 7 Wide after having a baby. Bunions are extremely common among mothers. This happens because the hormone relaxin, which affects the stretching of ligaments in the pelvis during childbirth, also affects the feet. Furthermore, the added weight gain puts more pressure on the feet.
9. Shoe modification can go a long way.
People often ask us whether they should have surgery done to “prevent the worsening of a bunion.” If you are having no pain or difficulty finding shoes right now, then you do not need surgery. Start off by shopping for shoes with roomier toe boxes and getting fitted for a pair of custom orthotic inserts, which gives you better arch stability.
10. You can bounce back quickly from a bunion procedure.
If it does boil down to surgery, you’ll be happy to know that this doesn’t involve a cast and crutches for months anymore. Modern techniques have most patients walking in a surgical shoe for six weeks. With a Lapidus bunionectomy, you can be walking with a little bit of extra protection at just two weeks. At this time, you can usually go back to work. More active jobs that involve a lot of standing, walking, or physical activity may require you to take two months off to recover fully.
Bunion Treatment & Correction in NYC
Dr. Josef Geldwert is a respected authority on bunions in New York City. He has published articles on bunion correction, in addition to lecturing on the success and complication rates associated with various types of bunion surgery. Dr. Geldwert is board-certified in foot and ankle surgery by the American College of Foot and Ankle Surgeons. He also teaches residents at Beth Israel and Mount Sinai. For expert care, book a consultation with Dr. Geldwert online here.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.