الأحد، 12 يناير 2014

What's That Huge Bump on Your Foot? Oh, It's Just Your Bone

Expert Author Janell Kennedy
There are a lot of funny-looking feet out there, but sometimes the funny-looking thing on a foot can cause incredible pain. Bunions are some of the biggest culprits that affect the feet by causing discomfort and affect one's vanity because they don't look very nice.
According to the American Podiatric Medical Association (APMA), a bunion is an enlargement of the joint at the base of the big toe, the metatarsophalangeal (MTP) joint, that forms when the bone or tissue at the big toe joint moves out of place. This forces the toe to bend toward the others, causing an often painful lump of bone on the foot.
Bunions can be formed because of a number of factors. Many times, particular types of feet are more susceptible to forming bunions. Therefore, if a certain foot type that is susceptible to bunions runs in the family, your likelihood for forming bunions is high. However, there are external factors that can cause bunions on any foot type or accelerate the formation of bunions on predisposed foot types.
Severe trauma to the foot, activities that put abnormal stress on the foot and even high heels, which don't properly distribute your weight on the foot, can be contributors to form bunions. There are several treatment options to try before getting to the point of surgery.
  1. Bunion pads and icing can alleviate pain to the bunion; try to avoid heels over 2 inches and wear wide shoes that allow for plenty of room for the bunion's protrusion. Shoes that are too narrow and rub against the bunion can cause additional pain and swelling.
  2. Orthotics come in many shapes and sizes. You've heard of Dr. Scholl's foot inserts. These are generic, but you can also get custom made orthotics through a podiatrist. Orthotics can delay or even negate the need for surgery because custom-made orthotics are specially designed for your foot only and force your foot to walk correctly. For severe cases, however, orthotics may only delay the need for surgery.
  3. Medication, such as anti-inflammatory drugs and injections can ease acute pain, but keep in mind that this only eases the pain temporarily. It is not a solution; eventually the pain will become acute again and no amount of injections will fix how the foot walks, which will only cause the condition to worsen without feeling the pain for a time.
  4. Physical therapy can provide some relief from bunion pain and sometimes ultrasound therapy can treat bunion problems and the related soft tissue.
  5. Surgery is the last resort. There are several different procedures that can be done depending on your age and bunion issue. Recuperation from surgery will easily take 2 months for most before they are back to a normal functioning level.
One thing my doctor advised me during my first consultation at 16 years old is though my case was severe enough to need surgery eventually, I should try to avoid surgery as long as possible. Too many people today make surgery their first option to correct something that is off with their body, which can cause additional pain or loss in mobility later because the timing was too early. My doctor advised me that once you cut into a bone and start putting pins and screws in there, you have immediately started the slow walk toward arthritis in your later years. Many people may have arthritis anyway, but it will come on sooner with any joint on which you've had surgery. So try to wait until the pain is unbearable.
One of the reasons my doctor advised to wait as long as possible is because many of these surgeries are not forever fixes. They may last a decade or a little more, depending on your activity and foot type, but you may find yourself needing additional surgery on the same foot at a later time, which will only exacerbate the future arthritis more and even lessen movement each time a surgery is done.
A misconception many people have about bunion surgery is that it will fix the visible bulge and make the foot look normal. This is not necessarily the case. My right foot has a bunion and has not yet had surgery. My left foot had been much worse than the right, so we performed surgery on that one first, at age 24, nearly ten years after my doctor advised me as a 16-year-old to wait as long as possible.
I have also provided an image of both of my feet for comparison purposes (view images of each foot individually and both together by clicking here ). As you can see, my left big toe is still at an angle and it still appears that there is a bunion there, but if you look at the right foot, the shape is different. I was concerned that a few months after my surgery, the bunion looked like it was coming back; my toe wasn't straight anymore. My doctor advised me that the fix was still in place. The purpose of the surgery was to make the foot walk correctly to eradicate the pain, not make the foot look pristine. This is likely what many doctors will tell you, so don't expect that your feet will look perfect for the rest of time... they won't.
In addition, my doctor advised that I continue wearing my custom-made, $300 orthotics as often as I could and forgo walking barefoot too much or wearing high heels. This is harder than it sounds because inserting these thick orthotics are particularly hard with women's shoes unless you remove the manufacturer's inner soles. And don't expect that your feet will be completely pain free all the time. From personal experience, changes in weather can cause temporary aching in your corrected bunion.
Recuperation times and experiences vary from person to person and surgery to surgery. I had my surgery at 24 to correct a severe bunion and nothing more. My recovery was 2 weeks on nothing but crutches, 2 weeks putting moderate weight (but not walking) on my foot with a post-op shoe, and about 6 weeks walking in a rehab boot. My father just had surgery on his bunion at 57 and had some hammer toes corrected. His recovery was a little different; his doctor advised him that he could put pressure on it the very next day after surgery and said his recovery time would likely be less than mine was.
We both had different surgeries, were different ages, and have different lifestyles, and will therefore have different results. You'll want to discuss every possibility to avoid surgery and if it turns out you must have surgery, make sure you have a detailed understanding of the operation and recovery.
There are a lot of videos out there to help you understand the best way to walk on a post-op shoe or boot. So even though the post-op shoes are not very fashionable, don't discount their value, and make sure you listen to doctor's orders.

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