Wearing Heels

Updated 3/2017-- all links removed as many are no longer active and it was easier than checking each one.


There is an article in my local paper today, "Bunion tip: If the shoe won't fit, don't wear it" It reminded me of this picture that I had saved from the September 10, 2001 issue of AMA News. I could not find it by searching their archives, so I scanned it in. The picture is the work of Susan Kingsley.

The article is by Jodi Farrell and lists 5 things to know about bunions. I have supplemented it with information from the American College of Foot and Ankle Surgeons.

It's the shoes

• Bunions are 9 times more common in women than men. The most common cause of bunions is the prolonged wearing of poorly fitting shoes. Usually the ones with a narrow, pointed toe box that squeezes the toes into an unnatural position.

What are bunions

• Bunions are often described as a bump on the side of the big toe. The visible bump actually reflects changes in the bony framework of the front part of the foot. With a bunion, the big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion's "bump." Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent. Usually the symptoms of bunions appear at later stages, although some people never have symptoms.

Prevention

• The best advise is to switch to shoes that fit properly and don't compress the toes. Don't select shoes by size because sizes can vary by brands and styles. Judge the shoe by how it fits on your foot. Make sure the toe box is big enough not to pinch.

Dealing with bunions

• Some shoes can be modified by stretching the areas that put pressure on your toes. Splints may be used to reposition the big toe. Orthotics may relieve the pain. If your bunion is caused by arthritis, anti-inflammatory medication may help.

Surgery

• When non-surgical treatment fails, the foot pain is severe, there is swelling or stiffness, then surgery may be suggested. The recovery period will be 6-8 weeks. While the bunion surgery can reduce the pain and align the toes better, it will not allow you to go on wearing too-small sizes or too-narrow shoes. Surgical options are covered in this eMedicine article.

These are the shoes I wear in the operating room

(and often out of the operating room).