What is your personal experience of bunions?
My mother has given me a lot of lovely gifts. Unfortunately, she also gave me bunions, which I inherited from her when I turned 40, 15 years ago. As a relatively short woman of five foot four, I’ve always loved my high heels. They make me feel feminine and finish off a fashionable outfit. So, in spite of the burgeoning bunions, I persevered with them for as long as I could, which - as a doctor - is probably not what I should have done. So much for “Physician heal thyself.”
For the first few years, my bunions didn’t bother me too much. My feet were hardly my most attractive feature, after all. But eight years ago, I noticed two things: one, that if I wore heels I felt pain and, two, that my beautiful shoes all started to look deformed - particularly on the right side where my bunion is much worse - as they moulded to the shape of my foot, which had a lump over the base of my big toe.
I’ve always walked a lot, but it got to the stage where the bony prominence was so painful - a sharp, piercing pain - that I was choosing not to walk and no longer getting my required 10,000 steps in. At first, I invested in a bigger handbag, so I could keep my pumps in it while I was walking - in sensible, wide-fitting, flatter shoes - between meetings.
More than anything, I wanted to avoid surgery. My lovely mum has had both her feet operated on for bunions, and I know just how long and how painful the recovery period is. I used to spend a lot of time in bare feet, and I’d manually push my right big toe back out into the neutral position. I also invested in gel pads from the pharmacist, so the bony prominence was cushioned within my shoes.
Mostly, I just limited my use of heels, which I hated. I can remember being at a very glamorous awards ceremony, wearing my stilettos, and having to take my right foot out of my shoe and stand on one leg, just to relieve the pressure and pain for a little bit.
As a result of all these measures, my bunions haven’t got any worse.
As a doctor, what treatment do you recommend for bunions?
Surgery is the only corrective cure for bunions. However, there are things you can do to relieve them and to stop them from getting worse. In the early stages you can buy splints from the pharmacist to hold your big toe in a straighter position. The downside is that these splints are bulky and restrict the type of footwear you can wear.
Gel pads are also very popular. If you stick them on your pressure points, they can relieve the pain and make it possible to wear otherwise agonising shoes.
If bunions are severe, then surgery is the only option. There are several different types of bunion surgery, which are often performed in combination. To start with, we can operate on the tendon, either to tighten it up or to lengthen it, if it’s pulling the toe out. Usually, you’ll also need bone surgery called an osteotomy, in which little slits are cut in the bone so the surgeon can force the toe straighter. Generally, the surgeon will put in some screws or plates to hold it in position. In the most severe cases, they will completely fix the toe in a rigid position. This is called an arthrodesis. Sometimes, the surgeon shaves off the bony prominence.
Why is National Bunion Day important?
National Bunion Day aims to raise awareness about just how many people suffer from bunions and I think it’s very important for people to know that they’re not suffering alone. Certainly there should be no stigma attached to this condition. Healthcare professionals are available to offer advice and support and there are footwear solutions to enable you to live comfortably (and fashionably!)
People are extremely self-conscious about their feet. I’ve lost count of the number of times patients with foot problems literally try to hide them under their chair, or protest “Oh God, my feet are just so ugly,” before I examine them. I reassure them that I’ve seen plenty of feet, of all shapes and sizes, before!
People often wrongly believe that bunions are self-inflicted. So many patients have said to me ‘It’s my own fault for wearing heels when I was younger.’ I really want to try to dispel this myth that high heels alone cause bunions. While we don’t know exactly why bunions occur, we do know that there’s a hereditary factor. If your mother and grandmother have them, it’s likely you will too. But wearing tight or ill-fitting shoes is likely to make them worse - and they are incredibly rare in tribal people who walk around barefoot.
Do people trivialise bunions?
There’s an idea that you shouldn’t bother your doctor with something as minor as a bunion. But being in constant pain and being unable to walk properly is not a minor concern. Bunions can have a severe impact on the quality of your daily life.