Are high heels to blame for Posh Spice's Bunion?

Rich or Poor, high heels or tennis shoes, child or adult, bunions can afflict any person at any time in their life. Posh Spice and Lady Gaga are just two examples of celebrities suffering with this sometimes painful foot condition. Bunions are the resulting bony prominence just below the big toe when it is pushing towards the rest of the toes. The big toe pushes towards the other toes, but the bony joint beneath it pushes outwards causing the big “bump” on the inside of the foot. When the big toe pushes on the other toes, it may come to rest underneath the second toe, which begins to contract called a hammertoe. This toe can also become painful when it pushes up causing a blister as it rubs on the shoe. Symptoms of a bunion may include: redness, swelling and pain along the inside of the foot. Critics of Posh Spice may blame her high heels for the deformity, but bunions are found in all people, high heels or not. Hereditary and biomechanical factors can also be a major contributor. In these cases, choice of constrictive shoes can exacerbate the problem, but not be the cause.

So, what are Posh Spice and Lady Gaga’s options for relief of their bunion pain? In my professional opinion, this depends on many factors. Some people have no complaints of pain. If the patient is elderly or it is a mild bunion deformity, I would typically recommend conservative options include shoe gear modification, orthotics, anti-inflammatories, and other options in which we could discuss. In patients complaining of pain and worsening deformity, surgery may become an option if conservative attempts fail. There are many different surgical options, but the most common involves trimming of the bone and realignment of the joint, which does incur a 6-8 week healing period. However simple the procedure, all surgery have some inherent risk.

Howard Stern teaches a lesson for Broken Toes

Doorways, desk legs, and bed posts, what do these things have in common? As Howard Stern found out, they are all enemies of our pinky toe. Two weeks ago, Howard Stern broke his little toe on the leg of his desk. Every week, I see patients with broken toes that have been stubbed on some object. Many times, they are presenting with some other pain, and the fact that they stubbed their toe just comes up in conversation. Like myself, many people live with an aching toe or foot after they have cracked it on some benign object in the house. The myth is that we cannot do anything for a broken toe, but all fractures should be diagnosed and treated. The fracture could be displaced resulting in the bone not healing properly possibly causing chronic swelling and pain if not surgically corrected. The other concern is that a non-displaced fracture could become displaced if we injure it further. Howard did the right thing by seeing his podiatrist. He had X-rays confirming the break in the fifth toe and confirming that it was lined up together ensuring proper healing. His podiatrist placed him in a fracture walking boot to immobilize it and is taping it to the fourth toe, called a buddy splint. Since bone takes 6-8 weeks to heal, he will have to put his running routine on hold for a few weeks at which time he can slowly work back into it.

A broken toe needs to be diagnosed and treated. If you fear that you may have broken your toe, please follow Howard Stern’s lead by seeing a podiatrist. We may not be able to speed up the healing time of it, but we can prevent it from becoming worse and causing pain years away.