Bad shoes not the main factor in bunions

Do bad shoes cause bunions?

Think those fancy, too-small shoes with the pointy toes caused that bunion? Genetics probably paid a bigger role, says Scott E. Woodburn, a fellow of the of the American College of Foot and Ankle Surgeons, who practices in Maryland. That is just one of the misconceptions people have about bunions, Woodburn said. He sets the record straight on other things people get wrong about the disorder.

What are bunions and what causes them?

A bunion, clinically known as hallux abducto valgus, is one of the most common structural deformities of the foot and ankle. By appearance, bunions are a small to large bump on the inside of the foot at the base of the big toe. They begin with the big toe leaning inward toward the second toe. This movement gradually changes the angle of the corresponding bones, causing misalignment and producing the characteristic bump. As bunions progress, they can become sore, inflamed and increasingly painful.

Who is most likely to get bunions?

Just about anyone can get a bunion — women and men, kids, adults and seniors. In fact, upward of two-thirds of Americans will develop a bunion in their lifetime and more than one in five adults currently suffer from bunions.

Many people believe that tight-fitting or wrong-size shoes, particularly worn during youth, cause bunions. This isn't the case. A bunion is most commonly due to genetics: an inherited condition passed down through your DNA. If one of your parents or grandparents had bunions, you may likely develop the condition at some point during your lifetime.

That said, regularly wearing some types of shoes — especially, tight, pointy-toed heels — can progress the development of a bunion if a person is already genetically predisposed.

What are some of the misconceptions people have about bunion repair surgery?

There are four general misconceptions about bunion correction surgery:

•It's terribly painful.

•An extensive healing period is required after surgery.

•Patients can't walk following surgery.

•Bunions tend to return, so there's no point in correcting them.

These assumptions are incorrect for the majority of patients. Bunions can generally be classified as mild, moderate or severe. Most people have mild to moderate bunions, and surgery can be completed with minimal pain and inconvenience. In fact, most patients walk out after their surgical procedure in a postoperative shoe or walking boot — no cast or crutches are required. And most can be back in a roomy, supportive athletic shoe in about three weeks.

In a smaller percentage of patients with severe bunions, a longer, nonweight-bearing healing process is required.

Most importantly, if patients have the correct procedure performed, closely follow the doctor's postoperative instructions and are realistic about the shoes they wear after surgery, there's minimal chance the bunion will return.

What are the new techniques for removing bunions?

Bunions can be treated nonsurgically with interventions such as wearing wider shoes. However, when bunion pain becomes a daily occurrence or limits a person's ability to enjoy hobbies or perform a job, surgical intervention can return a patient to optimal function.

Surgical techniques used today ensure minimal pain, earlier and improved mobility and decrease the likelihood that a person's bunion will return later in life. Advances in bunion repair surgery can be attributed to a number of developments, including:

•Improved surgical techniques.

•Better fixation devices.

•Enhanced anesthetic techniques, during and after surgery.

•Innovative orthotics, such as custom walking boots.

How long does it take people to recover using the new surgical techniques?

Information presented at the American Society of Foot & Ankle Surgeons' 73rd annual scientific conference last month shows that the majority of bunion surgery patients are able to walk independently with a surgical shoe or walking boot immediately following surgery and most can achieve full recovery in four to six weeks.

amcdaniels@baltsun.com

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