Bunion Pain – The Right Footwear

What do you consider when buying shoes, style or comfort? Majority of women, and men, buy shoes based on style alone and this comes at a cost. Bunions and hammertoes are common unsightly foot deformities caused by fashionable shoes. Many continue to suffer with the pain and put off any treatment, especially surgery, often due to a lack of information about treatment options.

A bunion is a bump at the inner side of the foot at the big toe joint, usually a progressively worsening condition. Hammertoes are contractures of the smaller toes. They can be present from early teen years through any age. Bunions and hammertoes are hereditary and are most often caused by an inherited faulty biomechanical structure of the foot that is then made worse by shoe choices.  It is not the bunion itself that is inherited, but the foot type that make a person prone to developing the condition.

Considering they are bony structural problems, the most effective treatment is surgery. Many people, however, postpone surgery due to certain misconceptions that are still widely present but, for the most part, are no longer applicable.

A very common misconception is that foot surgery requires a long healing time, necessitating extended time off from work and use of crutches and casts. While this was common in the past, new techniques allow patients to return to activities much quickly. Today, majority of patients having bunion surgery can walk immediately after surgery in a walking boot. Recent technological advancements in the area of bone fixation devices allow for this. Usually, the patient can advance to sneakers in three weeks and to most activities by 6 weeks.

While pain is very much subjective, foot procedures are no more painful than any other surgery. With newer approaches in surgery and postoperative management, patients experience very little pain. These more modern techniques utilize smaller incisions and less extensive soft tissue dissection which in turn, minimizes pain and healing time.

An unsightly scar is often cited as a deterrence by those considering foot surgery.  While scarring is often influenced by one’s genetics, there are several factors to consider in minimizing their visibility. Smaller incisions and placement on the inside of the foot where it is not visible from the top are possible. The same is true for hammertoes as well.  Plastic surgery techniques can be utilized to greatly minimize scarring.

Timing for bunion surgery is often debated. It was thought best to avoid surgery unless a bunion is very painful, but this slowly changing. Since these deformities worsen over time, it is sensible to address them earlier than later in life. There are also advantages to this since putting off surgery may worsen the condition leading to more aggressive procedures and longer recuperation.  Also, healing time after surgery usually increases with age.

Will my bunion come back after surgery? In most cases, patients will maintain their results and are satisfied long term, but recurrence is possible.  Certain foot types are prone to recurrence, such as those with excessive laxity of the foot joints. These patients should pay closer attention to shoe choices and should consider the role of orthotics after surgery. Another reason for recurrence is having had the incorrect procedure performed to favor a shorter recuperation.

Bunion surgery is a more common option nowadays and can be less daunting when done using the latest and most advanced techniques. The results will allow you to experience a better quality of life and put an end to the pain that conservative options cannot resolve. Discuss your condition with your foot and ankle surgeon and choose what would provide you with the best results. Ultimately, an individualized care plan should be created that is unique to your needs.

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Dr. Alencherry graduated from Cornell University with a Bachelor of Science degree in Molecular Biology and Concentration in Applied Economics & Management. He earned his medical degree in Podiatric Medicine and Surgery at the New York College of Podiatric Medicine in New York City. He continued his education with a four year Residency at the New York Hospital Queens, where he was appointed Chief Resident in his final year. He has comprehensive training in elective, reconstructive and trauma surgery of the foot and ankle. He also is trained in the most advanced non surgical and minimally invasive treatments of common foot and ankle conditions. He has an interest in treating the pediatric population and has experience treating congenital deformities. He is an Associate of the American College of Foot and Ankle Surgeons.In addition, he has completed several AO courses and has received training in external fixation and deformity correction techniques at the Ilizarov Institute in Russia. He is an active committee member for the New York State Podiatric Medical Association and the NYSPMA Young Physician section. He is a proud member of the American Podiatric Medical Association. He serves as the Director of Clerkship for the Podiatric Medicine and Surgery Residency program at New York Presbyterian/Queens. He is actively involved with Residency training and is affiliated with Long Island Jewish Hospital, North Shore University Hospital, Lenox Hill Hospital and Winthrop-University Hospital.