Bunions are a common problem that most people experience as a bony bump at the base of the big toe. A bunion, however, is more complicated than simply a bump on the foot.
When a patient has a bunion, the big toe angles in toward the other toes, a condition called hallux valgus. Bunions are most common in women, and the cause is most often unsuitable footwear.

Common Causes

A bunion is a prominence on the inner side of the foot, at the base of the big toe. The bunion usually forms because of a change in the alignment of the bones of the forefoot. This causes pressure and prominence of the base of the big toe. Irritation of the soft tissues surrounding this part of the foot causes further swelling and pain.

Causes of Bunions

Bunions are a common problem that can cause foot pain and difficulty wearing shoes. Bunions occur in about 30% of the population of most Western countries. They are seen most commonly in women and become more common as people get older.

Bunion Pain

Patients with bunions generally have one of two problems that can cause pain:

• Pain over the bump. As the big toe becomes more and more angled (pointing toward the other toes), the base of the toe becomes more and more prominent, forming the bunion. The bunion forms in part because of the new angle of the toe, and in part due to inflammation over the bunion surface. As the inflammation worsens, people can experience pain with shoe wear and walking.
• Joint pain.

As the bunion deformity progresses, the joint can become inflamed and painful especially with prolonged weight-bearing activities.

Non-Surgical Bunion Treatments

Bunion treatment should always start with changing footwear to relieve symptoms and to prevent the bunion from progressing. Shoes with a wide toe-box, padding, and good arch support can help relieve the bunion pain. Some people also find that ice and anti-inflammatory medications can help relieve the inflammation around the bunion.

Determining When Surgery Is Needed

Bunions can cause pain and difficulty wearing certain shoes. When simple treatments don’t relieve your symptoms, surgery may be considered for treatment of the bunion. What are the signs that surgery may be the right treatment for your bunion?

Bunion Surgery

When bunions cause pain and inflammation, and simple treatment is not effective for relief of symptoms, a surgical procedure may be recommended. The surgery performed for the treatment of a bunion is aimed at realigning the broken bone so the bunion will not return.

Preventing Bunions

The most helpful thing you can do to prevent the formation and the progression of bunions is choose proper footwear.

Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia, and it connects the heel bone to the toes and creates the arch of the foot.

Plantar Fasciitis Causes, Incidence, and Risk Factors

Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. The fascia may swell, and its tiny fibers may begin to fray. This can be painful and make walking more difficult. You are more likely to get plantar fasciitis if you have:

• Foot arch problems (both flat feet and high arches).
• Poor foot mechanics.
• Tight Achilles tendon (the tendon connecting the calf muscles to the heel).
• Shoes with poor arch support or soft soles.

Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis. The heel spur can form in response to the plantar fascia’s tug on the heel bone.

Plantar Fasciitis Symptoms

The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn. The pain is usually worse:

• In the morning when you take your first steps.
• After standing or sitting for a while.
• When climbing stairs.
• After intense activity.

The pain may develop slowly over time, or suddenly after intense activity.

Signs & Tests

The health care provider will perform a physical exam. This may show:

• Tenderness on the bottom of your foot.
• Flat feet or high arches.
• Mild foot swelling or redness.
• Stiffness or tightness of the arch in the bottom of your foot.

X-rays may be taken to rule out other problems.

Plantar Fasciitis Treatment

Your health care provider will usually first recommend:

• Oral and topical medications to reduce pain and inflammation.
• Heel and foot stretching exercises.
• Night splints to wear while sleeping to stretch the foot.
• Resting as much as possible for at least a week.
• Wearing shoes with good support and cushions.
• Orthotics to help support the mechanics of your foot.
• Steroid injections to decrease inflamation.

Other steps to relieve pain include:

• Ice application to the painful area. Do this at least twice a day for 10 – 15 minutes, more often in the first couple of days.
• Limiting barefoot walking.

If these treatments do not work, your health care provider may recommend:

• Wearing a walking cast for 3-6 weeks. It can be removed for bathing.
• Custom-made shoe inserts (orthotics).

Non-surgical treatments almost always improve the pain, but sometimes surgery is needed. Treatment can last from several months to two years before symptoms get better. Most patients feel better in nine months. Some people will need surgery, during which the fascia is partially cut to release tension.

Diabetes is a serious disease that can develop from a lack of insulin production in the body or due to the inability of the body’s insulin to perform its everyday functions. Insulin is a substance produced from the pancreas gland that helps process the food we eat and turn it into energy.

Neuropathy

Of the 25 million Americans with diabetes, it has been estimated that 25% will develop foot problems related to the disease. Diabetic foot conditions develop from a combination of causes, including poor circulation and neuropathy. Those suffering from neuropathy can develop minor cuts, scrapes, blisters, or pressure sores that may not be felt due to insensitivity. If these minor injuries are left untreated, complications may result and lead to ulceration and possibly even amputation. Neuropathy can also cause deformities such as bunions, hammer toes, and Charcot feet.

Contact The Progressive Foot Care in New York City at (212) 228-5230 to get an accurate diagnosis.

Poor Circulation

Diabetes often leads to peripheral vascular disease, which inhibits a person’s blood circulation. Poor circulation contributes to diabetic foot problems by reducing the amount of oxygen and nutrients supplied to the skin and other tissue, therefore inhibiting the healing of injuries. Poor circulation can also lead to swelling and dryness of the foot. Preventing foot complications is more critical for the patient with diabetes, since poor circulation impairs the healing process and can lead to ulcers, infection, and other serious foot conditions.

Your Daily Care

It is very important for those with diabetes to take the necessary precautions to prevent all foot-related injuries. Due to the consequences of neuropathy, daily observation of the feet is critical. By taking the necessary preventative foot care measures, you can help reduce the risks of serious foot conditions. If you have any foot problems or pain, contact Dr. Scott Melamed at The Progressive Foot Care in New York City –  (212) 228-5230.  We are here to provide you with the care you deserve for many years to come.

Foot Health Do’s

• Inspect your feet daily for blisters, cuts, and scratches.
• Always check between your toes.
• Wear shoes that are designed to protect your feet from injury.
• Avoid extreme temperatures. Test water with your hands or elbows before bathing.
• If your feet feel cold at night, wear socks.
• Inspect the insides of your shoes daily for foreign objects and rough areas.
• Shoes should be fitted by a foot-care specialist and be comfortable at the time of purchase.
• See your foot doctor regularly.

Foot Health Dont’s

• Don’t smoke.
• Don’t soak your feet in hot water.
• Don’t walk with bare feet on hot surfaces, such as sandy beaches or on the cement around swimming pools.
• Don’t use chemical agents for the removal of corns and calluses.
• Don’t walk barefoot.
• Don’t wear mended stockings and avoid stockings or socks with exposed seams.
• Don’t use oil or creams in between your toes.
• Don’t cut corns or calluses yourself. Instead, see your doctor.