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The question: It's sandal season and I'm not so keen on baring my feet due to unsightly bumps that I think are bunions? Is there anything I can do for this?

The answer: With summer just around the corner, it's a time to relax, enjoy the sun and release our feet from being bundled up in our snow and rain boots. While this can be freeing, if you have discomfort with the appearance of your feet, sandal season can be anxiety-provoking.

Bunions are a common deformity of the feet. It's estimated that one in three people suffer from bunions with the majority of those affected being women.

Let's understand how bunions develop so we can try to prevent and treat them.

Bunions are due to a change in the bony structure of the large toe joint known as the first metatarsal phalangeal joint (MTP). The first MTP joint is important in weight-bearing and movement of the foot. While bunions generally affect the large toe, they can also cause pain and damage to the other toes and increase the risk of ingrown toenails and calluses. While bunions are often simply seen as a cosmetic concern, over time they can cause significant pain and reduce your ability to bear weight, exercise and walk.

The bony changes that lead to bunions occur when our toes are squished together or deviated causing the large toe to be pushed against the smaller toes. Some people are prone to this misalignment of the toes due to genetics that may cause an overpronation (rolling inwards) of the feet, low arches or loose tendons. Another common cause of bunions is due to tight-fitting shoes. It is possible for both men and women to develop bunions, but women tend to get them more often due to footwear such as high heels or narrow shoes. High heels are a common culprit due to the increased pressure on the front of the foot, which strains the joint. This being said however, if you tend to pronate – even if you wear flats or flip-flops, bunions can still occur.

To prevent or stop bunions from getting worse, it's best to take the pressure off the MTP joint and improve foot alignment.

First things first: Wear the right shoes. Try to find shoes that are wide and flexible. If you're wearing heels, aim for a heel that is no higher than an inch to allow even distribution of your weight. If you wear heels at work, consider commuting to and from work in more comfortable shoes to give your feet a break.

To ease the friction against the bunion, cushion pads can be slipped into your shoes that will give your feet some comfort. Another option is to invest in custom orthotics, which can be made for you through a podiatrist. To create your custom fit, a podiatrist will take a mould of your foot and create an orthotic that will help support your feet and keep them well-aligned. Podiatrist care is generally a private health service and is covered by some insurance plans, but some communities may have free clinics available through your family doctor.

If these measures do not help and the bunions continue to affect your ability to function or walk, see your doctor. They may suggest other options and can refer you to an orthopedic surgeon who may be able to correct the deformity.

Our feet bear the brunt of carrying us around all day, so take good care of them early to prevent these complications from arising.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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