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Sandal season is finally here, which means many of us are thinking about our bare feet for the first time in months. While it feels great to liberate our feet from socks and boots, unpleasant foot issues such as bunions, blisters and calluses are potentially on display as well.
Bunions, in particular, can cause a great deal of discomfort. In severe cases, bunions can make walking — or even wearing shoes — extremely painful. We asked UChicago Medicine foot and ankle surgeon Kelly Hynes, MD, to answer some frequently asked questions about bunion treatment and for advice on keeping our feet healthy all summer long.
Hynes: A bunion is caused by a gradual change in the position of the bones that make up the big toe. It makes the bones stick out more on the inside part of the big toe. It is not a "growth" or callus.
Hynes: The best way to alleviate bunion pain is to avoid shoes that make the pain worse. Usually shoes that are wider at the toes or open-toed (weather permitting) are best. Splinting or bracing the toes will not affect how the bunion changes over time. Unless you also have other issues with the shape of your foot, custom insoles are not usually helpful for bunions either.
Hynes: Surgery is an option to consider when you are no longer comfortable wearing any kind of shoes and the pain interferes with your daily activities. It is not, however, a good idea to have bunion surgery just to improve the appearance of your feet, because there is risk involved. The potential benefit of undergoing the surgery should be greater than the risk involved.
Hynes: Surgery fixes bunions by realigning the bones to make the foot more narrow, so the bunion doesn’t stick out as much. We also cut off a small amount of bone on the bunion area and adjust the surrounding soft tissues so they stop pulling the bones in the wrong way. There are many different surgery options for bunions, so different surgeons might use different techniques with similar results. The size of the bunion also determines what surgery is the best one for you.
Hynes: All bunion surgeries require at least two weeks of zero walking and keeping the foot elevated to control swelling and promote wound healing. After those first two weeks, the recovery time will depend on the surgery that was done. Most commonly, you would not be allowed to walk fully on the foot for two to six weeks. If you have a larger bunion, the recovery time is longer, usually a full six weeks of not walking on the foot. Most people are also not able to fit into a regular shoe for at least two months after surgery due to swelling.
Hynes: Occasionally bunions come back after surgery, but this is not generally expected. If the bunion comes back, your surgeon would have to look for a reason why this happened. For example, is the bone not healing in the correct position or maybe the best surgery for the bunion was not selected in the first place.
Hynes: There is never any guarantee which shoes you will be able to wear after bunion surgery. For most bunion surgeries, if appropriate stretching is done and the motion of the big toe gets back to normal, you should be able to wear a variety of shoes -- possibly including a heel. But the goal of wearing high heel shoes again should not be a reason to have bunion surgery.
Hynes: Avoid shoes that cause pressure on the foot in any area to prevent blisters and calluses. Calluses can be softened with moisturizer and should gradually improve if there are no areas of increased pressure in your shoes. Wearing sandals that provide some support to the arch are generally better for the feet than flip flop-type shoes.
Hynes: Flip flops don’t generally cause foot problems, but they do lack support. As we age, the soft tissues of the feet, such as tendons and ligaments, can lose some of their strength. When this occurs, it is important to support our feet with a shoe that has some arch support and a stiffer sole than flip flops generally offer. There are many types of sandals that provide arch support and can better prevent aching, tired feet compared to flip flops.
Hynes: Keep your feet moisturized and avoid walking in bare feet outside. This can cause calluses and injuries. If you are doing any hiking or walking, make sure you wear supportive, well-fitted running or hiking shoes to avoid pain and blisters. If you plan on being more active, doing some stretches, especially for your calves, can prevent overuse injuries to the feet and ankles.
Dr. Kelly Hynes specializes in the diagnosis and treatment of foot and ankle conditions, including trauma, sports injuries, forefoot deformity and degenerative disease.Learn more about Dr. Hynes