Nail Clinic: Bunions

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Bunions are often painful for clients, but your services can help ease the hurt.

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.

Bunion Basics
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.

Nail Clinic: Bunions (page 2)

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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.”

Tech Intervention.
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.

Nail Clinic: Bunions Statistics

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*Sources: Thanh Dinh, DPM; Carol Frey, MD; USA Today;

Nail Clinic: Bunions—Tech Talk

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Nail technicians offer their approach and advice for working with clients who have bunions:

“Several of my clients suffer from bunions. Many of them come in regularly to enjoy a soak in the pedicure tub and the softening cream used during the foot massage. I’ve found that during the massage, it’s important to use extra care around bunions, as they can be tender to the touch. In my experience, most clients find temporary relief from the soaking and massage, as long as the area is treated gently.” —Valerie Day, Amy’s Full Service Salon, Marshfield, MO


“I have one client who has bunions and she just had foot surgery for the problem. I do gel toes on her regularly, so I just make sure I’m aware of it when I’m massaging. She was so tender anywhere near the affected area before the surgery, and still is very sensitive, but she’s happy she had the surgery.”—G. Elizondo, D’Hair to Be Different Salon, Las Vegas, NV


“My advice to techs is to partner with a podiatrist in town and establish a professional referral relationship. The professional relationship helps the nail tech practice under her scope while also providing the next step. I try and get all of my clients to purchase sandals with built-in toe separators—they really do help with maintaining proper posture of the foot.”—Millie Haynam, Natural Beauty Salon and Academy, Twinsburg, OH


“I have several clients who have bunions. I try to file the hard callus and smooth it, but I never take it away completely.”—Kathie Kirkpatrick, Diva’s Day Spa & Salon, Crockett, TX


“I have about five clients with bunions, and I myself have bunions on both of my feet, so I understand how they feel. I make sure that I’m very careful during their pedicures by not applying too much pressure; it can be very painful if filed or massaged too hard. A warm foot soak also helps ease the discomfort. I’d advise techs to be extra-gentle with feet that have bunions and to refer the client to a podiatrist.”—Nancy Donatone McCoy, McCoy Nail Salon, Walnut, MS