Amal Clooney, Victoria Beckham and Catherine Zeta-Jones all have one health problem in common – they all suffer from bunions.
Regardless of fame, fortune or stature, bunions - medically known as hallux valgus - inflict pain and discomfort of thousands of women.
But are bunions a result of wearing badly fitting shoes, or something else? Here are a few facts about the painful podiatry pest and what you can do to relieve the pain of them:
What exactly is a bunion?
Dave Wein, podiatrist at Carnation Footcare, explains that a bunion generally comprises two elements.
Firstly, where the big toe (known medically as the hallux), rotates and moves away from the middle of the body at its joint, and the bone behind the big toe that forms the other half of the joint (known as the first metatarsal), rotates and turns into the middle of the body.
This enlarged joint then rubs against shoes, causing a protective, fluid filled sac (known as a bursa) to form over the rubbed area.
This often becomes inflamed and painful or sore.
Why do some people suffer from them?
Dave explains: “Generally 23% of all adults suffer from bunions to some extent but they are more prevalent in women over 65 years. The exact cause of bunion formation remains unclear but it is believed to result from a number of factors rather than just one.”
Are bunions hereditary?
In some cases, yes, says Dave.
“A hereditary component has been identified, which is stronger in men than women, even though women have a higher prevalence of bunions,” he says.
“The presence of a first metatarsal that rotates and turns into the middle of the body (known medically as metatarsus adductus) from birth is associated with the development of a bunion.
“Hypermobility, such as Ehlers-Danlos syndrome and other connective tissue disorders like rheumatoid arthritis that have a hereditary component can lead to the development of bunions.”
Is it true that bad shoes cause bunions?
“Even though footwear is logically implicated in the cause of bunions it remains scientifically unclear,” Dave comments.
“However, shoes that are not long enough in children and that are not wide enough in adults are associated with bunion formation. High-heeled shoes worn by women are also associated with bunion formation and are likely to be the answer why women have a higher incidence of bunions than men.”
Can you ever get rid of them, or is surgery the only way?
Unfortunately, it’s extremely unlikely you could correct a bunion once it’s formed without surgery – but you can help them, along with the pain and symptoms associated with them.
“The symptoms caused by a bunion can be treated and successfully reduced through the use of good fitting footwear, protective padding, foot exercises, massage and sometimes manipulation, rigid and/or elastic taping, external splints, Marigold Therapy and non-steroidal anti-inflammatory medication.
“Even the amount of deformity in the big toe can be reduced providing the big toe joint has sufficient flexibility.
“For true bony correction of the bunion though, surgery is necessary but should really only be considered if there is no relief from non-surgical treatments and there is a high degree of daily pain. Purely cosmetic surgery where there is no pain or other symptoms, given the potential risks from surgery, is inadvisable.”
How can you make shoes more comfy when you have bunions?
Dave advises: “When choosing shoes ensure that they are the correct length i.e. your longest toe is not touching the end of the toe area (toe box) and there is sufficient width in the toe box to accommodate the increase in your forefoot width.
“This may not be fully possible if your bunion is quite prominent, so choose shoes of a softer flexible material to allow expansion without an increase in friction to your bunion. If you are wearing open shoes choose a pair where the open area does not end over your bunion, or if there is a strap then this should not cover your bunion.
“When wearing heels avoid a pointed toe box, keep the wearing time to a minimum to prevent friction to the bunion and remove the shoes where possible during the period of wearing. At all times ask yourself, ‘Are my shoes comfortable?’ If not, change them and always have your feet measured before buying any new pair as your foot dimensions may have changed.”
What bunion exercises are there to relieve the pain?
According to Dave, there are a number of exercises you can do to strengthen both the muscles that arise and finish within the foot (intrinsic muscles) and those that start outside of the foot but end in the foot (extrinsic muscles or calf muscle) “to achieve symmetry of motion”.
4 bunion exercises:
1. Place an elastic band around both big toes on each foot, then turn the feet outwards, placing a stretch on the big toes and hold for 1 minute then relax for 1 minute, repeat five times.
2. Firmly grasp your big toe and rotate it in as large a circle as is comfortable at the big toe joint for 10-15 seconds clockwise and anticlockwise. If you have painful arthritis, however, do not perform this exercise as it may aggravate the condition.
3. Using a towel wrap it around the big toe and pull the towel back towards you whilst at the same time pushing your big toe downwards against the pull for around 4-5 seconds, repeat 15 times per day.
4. Place a towel on carpeted floor and using all your toes by curling them, pull the towel back towards you, repeat once in the morning and once at night.