Working as a nail techician, you undoubtedly encounter various foot abnormalities on a daily basis. A common foot condition, particularly in women, is bunions. Although it is widely believed that tight shoes are the culprit, many experts have found that your favorite stilettos don’t actually cause bunions. In this Nail Clinic, we’ll look at the facts about bunions, how they can be treated and how you can help clients who suffer from them.
According to the American Podiatric Medical Association, a bunion (also known as hallux valgus) is an enlargement of the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place. Such a disjointed arrangement “involves some drifting of the great toe toward the lesser toes,” elaborates Carol Frey, MD, director of orthopaedic foot and ankle surgery at the West Coast Center for Orthopaedic Surgery and Sports Medicine in Manhattan Beach, California. This leads to a lump of bone on the inside of the foot, just below the big toe, which often causes pain.
Medical professionals believe there are multiple causes of bunion deformities. “Currently, the prevailing theory is that they’re caused by faulty biomechanics of the foot, which is largely an inherited trait,” says Thanh Dinh, DPM, member of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center in Boston. “It’s commonly thought that improperly fitting shoes cause bunions, but it is more likely that bunions are aggravated by these types of shoes and are not the cause itself.”
Because uncomfortable shoes can exacerbate the problem, women are particularly prone to bunions. Shoes that are too tight, notes Frey, “especially high-heel shoes with a narrow or pointed toe,” are often the culprit. Since women are most likely to cram their feet into these types of footwear, this leads to a much higher occurrence of bunions in women. Frey estimates that 90% of cases are reported by women, while Dinh suggests that women are predisposed to the problem over men by a 2-to-1 ratio.
The symptoms of a bunion are easily detected. According to the American College of Foot and Ankle Surgeons (ACFAS), warning signs include pain or soreness, inflammation and redness, numbness in the affected area or a burning sensation. Other conditions that may appear are calluses on the big toe, sores between the toes, an ingrown toenail or restricted motion of the toe. Keep in mind that some clients may experience more symptoms and pain than others, depending on their activity levels and habits. “People who are on their feet for longer periods of time tend to be more symptomatic,” says Dinh. Athletes or dancers, for example, may have a higher incidence of irritation. Also, age is not necessarily a factor, as children and adolescents also experience bunions due to their foot type and genetics.
Remedies for bunions range from mere habit changes to surgery. ACFAS recommends the following noninvasive treatments for those who suffer from bunions:
However, these do not cure the problem. “All of these measures simply decrease the pain symptoms, and do not address the deformity itself,” notes Dinh. Surgery, on the other hand, tackles the problem directly through a procedure that cuts away the bone to remodel its structure. “Whether to perform surgery depends on the severity of the problem,” continues Dinh. “Most procedures will work for the long-term, but the return of a bunion is a risk, especially in younger individuals.”
If your client suffers from bunions, this is a great opportunity for you to provide your own brand of TLC. Besides educating your client about the possible pain-alleviating solutions mentioned above, you can actually help diminish some of the discomfort associated with the condition. “A nail professional can proceed with massage or soft tissue work without problems,” says Frey. “Many clients will benefit from this when they have a bunion.” However, some clients might experience discomfort from massage, so work gently and make sure to ask your client if your technique or pressure needs adjustment.
Recently there have been reports that pedicure sandals with built-in toe separators can help clients with bunions. “These can temporarily realign the joints and decrease pain symptoms, though they don’t correct the problem,” Dinh says. “They can make clients feel better for the short-term.” If your client suffers from bunions, suggest that she invest in a pair so her feet can get some temporary relief.
Bunions are bound to crop up at your station—in fact, they’re likely already a commonplace condition in your salon. As always, asking questions and using your powers of observation can help you cater to every client’s needs to the best of your ability. After all, with so many women affected by this problem, it makes sense to let your clients know the facts—and then come to their aid by providing that tender touch nail techs are known for!
Tracy Morin is a freelance writer and editor based in Oxford, MS.
surgery to fix bunions are satisfied with the results.