Several features combine to create the infamous bunions that are the plague of every woman who loves to wear tight fashion shoes. Like many of our physical features, bunions tend to be inherited, but get worse with time. Severe bunions can be seen even in 12 year olds, but rarely in males. In the diagram above you can see the big toe joint going out of shape with the typical large bump (subluxed joint and thickened bursa), the widened foot and the end of the toe angling inwards.
The shape of the foot however, does not usually have much to do with the pain of a bunion. Bunion pain is most often caused by the wider foot and its prominent bump rubbing against the side of the shoe. The bursa (a small, flat, fluid-filled sac that lies just below the skin on the outside of the bump), becomes inflamed and thickened. Even shoes that you once thought were loose may be tight enough to create a great deal of pain. Wearing wider shoes usually
eliminates the pain, but the bump makes fitting tight shoes very difficult.
Surgery is the only alternative to reduce the size of the bump and the hallux valgus angle. There are several different procedures which have both pros and cons . Most patients will try other methods of managing the condition initially.
Bunion formation is likely accelerated by hyperpronation (excessive lowering of the arches) because of the excessive weight placed on the big toe joint during the pushoff phase of gait, forcing the hallux into further valgus. More friction between the bursa and the shoe occurs with a hyperpronated foot. Once the hallux valgus angle is significant it destabilizes the foot during pushoff since the great toe is not available for push off.
|What to Do|
The pain of hallux rigidus (osteoarthritis of the great toe) or
conditions like gout can sometimes mimic the pain of bunions so see your doctor for a proper assessment. Tight, pointed toeboxes force the hallux into greater valgus for hours at a time and should
therefore be used in moderation. Shoes should be devoid of seams
since stitching does not stretch easily. Pumps should be high in the
vamp, covering the bunion completely, rather that the more classic
style that cuts across it. Bunions that ache at night can be relieved
with ice and a bunion splint that straightens the toe temporarily.
Constant use of a hallux valgus night splint may reduce the
ligamentous contractures associated with long term bunions. Gel
toe spreaders may also provide relief. Pre-stretch the bunion area
at the shoe repair shop rather than make your foot do the work, or
purchase a “ball and ring” stretcher made for that purpose. Wear a
heel height that is comfortable, and wear supportive walking or
running shoes with a roomy toebox whenever possible. Wear
orthotics or arch supports as your doctor prescribes them to control
|What CWG Does|
Clinical and Biomechanical
assessment general and specific, our hands and minds will outdo technology for a long time yet Lifestyle weight and exercise management and motivation
Our greatest strength, incredibly more effective and higher quality
than anytime in our 14 year history. Lab foreman Jeffrey C. sets the
bar on quality and service in manufacturing
how to choose a shoe, recommending the correct footwear to suit
structure and pathology
One Stop, Custom Fit Shoe Shop
our own selection of quality brand name footwear will suit most patients needs for those who prefer the convenience of a personalized fit by Pedorthic Assistant Caroline D., BSc.(Kin).
Service, Service, Service
making an appointment at CWG means talking to a real person who
can answer your questions. Friendly and knowledgeable our
receptionists Linda A. and Linda W. make it a pleasant experience to deal with CWG.
“Whatever it Takes”
is Guaranteed the severity of some foot-related conditions means
that repeat visits and sometimes replacement orthotics are
necessary to conquer. If your orthotics are not providing relief, don’t expect a bill for the time and effort we put into follow up appointments.