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Are You Bothered by Bunions? One-third of seniors have this uncomfortable condition.

If you've noticed a painful swelling on the side of your foot at the base of your big toe, you may have a bunion. About one-third of Americans age 65 and older have the condition, with women particularly susceptible. Unfortunately, many people suffer the discomfort of bunions for years without doing anything about them--but they can be treated, and simple precautions can help prevent them from recurring.

What Causes Bunions? A bunion results from stress on the metatarsophalangeal joint (where your big toe connects to your foot) that causes bone and tissue in the joint to grow until it eventually forms a bump that forces the toe out of its correct alignment. "The fact bunions cause the big toe to lean towards your other toes means the other toes also may become misaligned," says Bryan C. Markinson, DPM, associate professor of orthopedic surgery and chief of podiatric medicine and surgery at Mount Sinai. "Very often, the second toe overlaps the big toe--in fact, in many cases this is the reason people realize they have a bunion, as the main discomfort is from the shoe rubbing on the second toe."

The pain caused by a bunion ranges from mild to severe enough to affect walking. "As well as pain and swelling in the joint, you may experience a burning sensation that alternates with numbness, and the skin in the area--including the sole of your foot--may become inflamed and tender," Dr. Markinson says. "In many cases, the deformity results in the transfer of weight-bearing stress to the adjacent second metatarsal bone, creating a painful callous on the bottom of the foot."

Treating a Bunion Dr. Markinson emphasizes that conservative treatment should be the first line of bunion care before surgical methods are considered, but while these measures can ease the discomfort of a bunion, they won't reverse the bone deformity. You can purchase bunion cushions or pads at most pharmacies--these are designed to stay in place and protect the joint from the friction of walking in shoes. Other options include fitted "sleeves" that incorporate a gel pad--some come with splints or toe spacers to help your toes maintain correct alignment. Your doctor also may recommend custom-made shoe inserts called orthotics, which help hold your toes in the correct position.

Ice packs can help to ease swelling in the area, and it's vital to ensure that your shoes have adequate space in the toebox, so that your toes aren't forced into an unnatural position. "Consider the depth of the toebox as well as the width," Dr. Markinson advises. If you need to take painkillers, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil[R], Motrin[R]), ease inflammation--however, discuss their use with your doctor, since they are linked to side effects in seniors.

Surgical Options If conservative measures don't reduce your discomfort and slow the progression of the bunion, and your mobility is severely affected, surgery can correct the deformity in the joint, remove the bump, and restore pain-free function. "For a moderate bunion, the procedure involves removing deformed bone and tissue, and correcting the alignment in the joint, which may require small surgical screws or a plate to hold it in the correct position afterwards," Dr. Markinson explains. "Full recovery generally takes six to eight weeks, and you will need to wear a surgical boot afterwards to protect the area. Keep in mind that the surgery carries a risk of infection, prolonged swelling, stiffness, numbness, and scarring. The procedure is less simple for advanced bunions--your surgeon may need to remove bone and fuse bones together. "The recovery time afterwards may extend to several months, with some of that time spent in a cast and using crutches to walk," Dr. Markinson notes.

About 85 percent of people who have bunion surgery report less pain afterwards--but Dr. Markinson cautions that bunions can recur, particularly if you habitually wear improper shoes.

Caption: A bunion forces the toes out of alignment.
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Title Annotation:BONES & JOINTS
Publication:Focus on Healthy Aging
Geographic Code:1USA
Date:Apr 1, 2018
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