As Victoria Beckham’s bunions hit headlines in UK, leading podiatrist Martine Abrahams shines a light on this painful and ugly condition
As Victoria Beckham’s bunions make headlines in the UK (once more!), I thought I would explain the condition, solutions and recovery for those of you in a similar predicament.
Bunions are certainly not life threatening, but can cause a great deal of grief, pain and discomfort for sufferers. They can be hereditary, and can often be caused by external pressure from ill-fitting shoes or regular wearing of vertiginous heels – á la Posh Spice!
A bunion is a bony lump that forms at the base of the big toe, where it attaches to the foot. Often, the big toe deviates towards the other toes. When this occurs, the base of the big toe pushes outwards on the first metatarsal bone – which is the bone directly behind the big toe – forming a bunion.
As a bunion occurs at a joint where the toe bends during normal walking, the entire body weight rests on the bunion at each step, causing a great deal of pain. They are also vulnerable to excess pressure and friction from shoes and can lead to the additional problem of calluses and painful corns.
Bunions are usually easily recognised thanks to their classic shape, but often an X-ray will be performed to check the extent of the deformity. A blood test might also be arranged to rule out various forms of arthritis. A formal diagnosis enables the best course of treatment – insoles, orthopaedic shoes, medication, surgery or other treatment…
Many bunion sufferers live with their toe deformity, wearing increasingly comfortable shoes and avoiding footwear that cause severe pain. It’s probably a good idea to consult with a podiatrist who will then refer you on to a Podiatric Surgeon if surgery is a viable option.
You podiatrist may suggest over-the-counter pain relief, as well as medication to relieve the swelling and inflammation. A heat pad or warm footbath may also help relieve the immediate pain and discomfort – ice packs can also help.
If your bunion isn’t persistently painful and you take action early on, changing to well made, well-fitting shoes may be all the treatment you need. Your podiatrist may advise an orthotic device that can improve and realign the bones of your foot (i.e. bunion pads, splints, shoe inserts, bespoke insoles and uppers…)
Surgery may be recommended for some bunions, but only when symptoms are severe enough to warrant such intervention.
Surgery for a bunion, called a bunionectomy, is done in hospital usually under general anaesthesia. The surgeon can often realign the bone behind the big toe by cutting the ligaments at the joint. For a severe bunion, you may need to have the bone cut in a technique called an osteotomy. Wires or screws may be inserted to keep the bones in line, and excess bone may be shaved off or removed. Potential complications of surgery include recurrence of the bunion, inadequate correction, overcorrection (the toe now points inwards), continued pain, and limited movement of the big toe.
It is suggested in the attached press clipping, that bilateral bunion correction cannot be performed – this is not the case, often sufferers choose to have both feet operated on at the same time as this obviously reduces overall ‘downtime’. However, bunion recovery can be painful and difficult, with the patient having to rest with their feet up for several weeks whilst the bone heals.
And, bad news for Victoria Beckham, heels and shoes with tight toe space must be avoided for several months after surgery – up to a year in some cases!
Bunions are unsightly and cause a great deal of discomfort on a daily basis. Seek advice and help from your local podiatrist, as there are many ways we can help make life easier for you – and your feet!