Teetering our way to toe trouble

Published: 2011-08-10 10:56:33

 It is astonishing to see how fashionable very high-heeled shoes for women have become again.

Unfortunately, high heels are also associated with bunions, which are decidedly unfashionable.

A bunion is a structural deformity that occurs where the big toe joins on to the bones of the foot. These deformities can be very painful.

The swelling is simply a swollen bursa sac and the bony deformity is grown on the point where the bone of the foot (called a metatarsal), joins the bone of the toe (called the phalanx). What happens next is that the big toe starts leaning towards the second toe rather than being straight.

Bunions do not occur overnight. They develop slowly and so they are common in the elderly. Some people who have bunions are lucky enough to have no marked symptoms so that their only problem is selecting appropriate footwear. However, for most people bunions are painful and choosing shoes is very difficult.

Bunions occur because of the nature of the foot, and it is the nature of the type of foot you inherit that is the problem. Wearing shoes that squash the toes in may aggravate the problem, but it doesn't cause the bunions in the first place.

Certainly if you wear high heels and squash your toes you will exacerbate the formation of the bunion and you may get symptoms much sooner than you would have otherwise.

This is probably why women appear to be more affected by bunions than men. People who spend long periods of time on their feet are also more prone to developing bunions.

The diagnosis of a bunion is not difficult as the appearance is quite characteristic.

If the bunion does not cause any problems or produce any symptoms it is best left alone. Sufferers may visit a podiatrist who can discuss the best way of management, often by wearing appropriate shoes and looking at changing behaviour (such as long periods of standing).

Sometimes surgery is necessary, both for older people and for younger women who have been wearing inappropriate footwear. The surgery is not simple because it involves realigning the nerves, bones and ligaments. Orthopaedic surgeons often try to handle this condition in a conservative way and leave surgery for those who are severely affected by the pain.

Recovering from bunion surgery is not straightforward and frequently the joint can be swollen or stiff for quite a long time afterwards.

Shoes are now sold in different widths, especially for men, but it remains important to convince women that wearing tight, pointy- toed and high-heeled shoes is not good for their feet. Being a slave to fashion may have repercussions later.