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The Doctors Book of Home Remedies II: Bunions

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Bunions

A bunion is an overgrowth of bone that causes your big toe to thrust out beyond the normal profile of your foot. And while a lot of people blame the shoes they wear, bunions are actually a hereditary problem: People in the same family are likely to have similar bone structure. Along with the overgrowth comes pain, as that bunion encounter's the everyday assault and battery of shoe leather.

Bunions are ten times more common in women than in men. And because of the kinds of shoes that women wear, the pain is worse. The first sign is growth at the base of the big toe--the result of years of wearing too-tight shoes that cause pressure. Eventually, in some people, the enlargement of that growth forces your big toe to deviate toward the second toe. Since high heels make the front of your foot slide forward, every time you slide a pair on, you're putting your bunion-prone or bunion-afflicted big toe under pressure. Eventually the pressure may become so painful that just walking can be difficult.

The only way to remove bone overgrowth like bunions is with surgery. But if you don't like the thought of the scalpel, here are some homegrown healers to help keep you one step ahead of the pain.

Wear running shoes. I recommend that my patients with bunions wear running shoes as often as possible," says Pennsylvania podiatrist Robert Diamond, D.P.M., who is affiliated with Muhlenberg Hospital Center in Bethlehem and Allentown Osteopathic Hospital. "Running shoes have a roomier toe box, which is essential for people with bunions. And since they're made from softer materials than regular shoes, there's not as much pressure." (Walking shoes work just as well, adds Terry Spilken, D.P.M., a podiatrist and adjunct faculty member at the New York College of Podiatric Medicine in New York City, and you might prefer them for appearance' sake.)

Heat it up. "Applying a heating pad to bunions on a regular basis helps increase blood flow, which breaks up the inflammation," says Dr. Spilken.

Are You Bunion-Prone?

Those with flat feet or low arches are most likely to develop bunions, says Terry Spilken, D.P.M., a podiatrist and adjunct faculty member at the New York College of Podiatric Medicine in New York City. "That's because flat-footed people are the most likely to pronate, which is an inward rolling of the foot. And that inward rolling puts more pressure on the area where bunions tend to develop."

The answer: If you're severely flat-footed or a pronator, wearing specially made orthotic devices can help keep you from pronating and thus developing bunions. The devices must be prescribed by a podiatrist and cost between $200 and $400.

Try hands-on healing. Regular massage in a perpendicular motion also helps ease bunion pain, says Dr. Spilken. He recommends that you massage across the bunion (and across the foot): "That offers more relief than massaging along the foot."

Ease the pressure with sling pads and spacers. There are various over-the-counter products that take the pressure off the bunion and ease the pain. A sling-type pad "pulls" the big toe away from the second toe. "It takes the pressure off the bump. And there are spacers that you place between the big and second toes," says Dr. Diamond. "They won't straighten the big toe, per se, but they do help relieve some of the pressure." Though moleskin pads are often used by bunion sufferers, Dr. Diamond says that they're less effective than the sling-type pads and spacers.

Go barefoot or wear sandals. The real culprits are shoes that rub your toes. So if you want to prevent pain from bunions, go without shoes as much as possible to ease pain and prevent a worsened condition. Whenever you're home (or in any situation where footwear is optional), go shoeless. If you can't, wear sandals or other open-toed shoes as much as possible.

Make sure your shoes fit correctly. When you must wear shoes, make sure they fit as well as possible. When you have the proper fit, the end of your longest toe should be a finger-width short of the end of your shoe, according to Dr. Spilken. "Width-wise, the shoe should be just wide enough to allow you to fit a finger between the inside of the shoe and the side of your foot. In front, the shoe should not rub against your big toe or littlest toe," he says. If you already own shoes that don't pass this measurement test, you can stretch them. Shoe repair stores provide this service for a reasonable price.

When Is Surgery Necessary?

Bunion surgery can be a simple outpatient procedure that can eliminate a bothersome bunion for good. Recovery usually takes about four weeks, but you'll probably need only a few days of complete rest and elevation.

"There are no hard-and-fast rules for determining who needs surgery, but if the bunion is painful or deforming your toes, then surgery is generally recommended," according to Pennsylvania podiatrist Robert Diamond, D.P.M., who is affiliated with Muhlenberg Hospital Center in Bethlehem and Allentown Osteopathic Hospital.

Most experts agree that if your bunions interfere with your lifestyle, causing you pain and keeping you from doing what you'd like, you should have surgery.

Soak your feet, saltlessly. A good hot soak in Epsom salts is the most popular home remedy for bunions. But perhaps you don't need any salt. "Just soaking your feet in hot water is enough to reduce inflammation and ease pain," says Dr. Spilken.

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