bunion ('bun-yən) n.  a bump on the side of the foot caused by an enlargement of the first joint of the big toe.

I have good news. Bunions are not caused by high-heeled, pointy-toed shoes. The shoes may cause blisters, calluses, and back aches, but they won’t cause bunions. Bunions are caused when the arch of the foot drops. “This forces the joint of the foot to carry a heavy load over long periods of time in ways it was not designed to,” says Dr. David Martin, a chiropractor in Johnson City, N.Y.  The toes begin to bend outward to compensate for the dropped arch, adding pressure to the joint. “The pressure causes extra bony growth and fibrotic tissue to build up around the joint, and a bunion develops,” says Dr. Martin. Left untreated, bunions can become quite painful and the joint can bend so severely that the big toe crowds out the other toes of the foot.

Heredity is the main culprit of misaligned bones and of the dropped arch that causes bunions, but it’s not the only one. A foot injury can cause a misalignment, as can a neuromuscular disease. However, since so many bunions can be attributed to your genes, people who have a predisposition to bunions should be proactive to avoid developing them.

For example, people with flat feet are more likely to develop bunions because of the lack of arch support in their feet. This doesn’t mean that bunions are guaranteed to develop if a person has flat feet, but it does mean those with flat feet need to be more proactive about foot care and bunion prevention. “Custom orthotics are often a wise investment,” says Dr. Martin. “Orthotics will support the arch and reestablish more normal movements,” he says. Plus, regular chiropractic adjustments of the foot will be beneficial. Additionally, clients with flat feet should avoid high-heels and narrow shoes. We’ve established that shoes don’t cause the bunions, but they do add pressure to the joint. If that joint is under pressure from a low arch, poor footwear will add extra pressure to an already over-used joint.

To Reduce the Pain - To alleviate the pain associated with bunions, clients can soak feet in a warm bath, take a pain reliever such as Tylenol or Advil, or apply ice to the inflamed area. Pedicures would provide clients relief from the pain of bunions, but unfortunately, they offer only temporary comfort. Once pain develops from a bunion, it’s likely the condition will continue to deteriorate. If a client complains of bunion pain and indicates the pain is affecting her daily activities, techs can recommend she consult her doctor to discuss treatment options, including surgery. Many people have expressed relief from bunion pain after surgery, but it’s not without its side effects. Side effects could include a restriction of movement, continued pain, or even a recurrence of a bunion. As in every case, surgery should be considered the last option after all non-invasive treatments have been ruled ineffective.

There are many types of bunion surgeries, though often surgery will include a full or partial bunionectomy. According to the Mayo Clinic, “A bunionectomy includes removing the swollen tissue around the big toe joint, straightening the toe by removing part of the bone, and permanently joining the bones of the affected joints.”

A nail tech can’t heal or treat bunions beyond trying to relieve some of the pain associated with them. However, techs are in a unique position in that they can educate clients on the cause of bunions, dispel myths, and offer professional advice. Techs can offer suggestions that will provide immediate relief, such as wider shoes or bunion pads. They can also offer solutions clients may have never heard of, such as a visit to a chiropractor for adjustments and orthotics. Your suggestions of these early, non-invasive treatments could reduce your client’s discomfort from bunions, and they may even help her avoid surgery.

What’s a Tech to Do?    When a client comes in with a bunion, techs can inform them of the root problem of bunions: a flattened arch and a misaligned, highly-pressured joint. Techs can recommend a number of non-invasive treatments. It should be noted that non-invasive treatments don’t cure bunions. However, they can provide relief of the pain, and they may prevent the bunion from becoming more severe.

Non-invasive treatments include orthotics and chiropractic care. (Orthotics are available through chiropractors or podiatrists.) Another non-invasive treatment would include bunion pads, which provide relief from the irritation of rubbing shoes. Techs can also recommend their clients wear “flexible, non-rigid shoes,” says Dr. Martin. Shoes should be wide and roomy. A pedicure with a warm water soak may provide temporary relief.

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