Do you want to wear the cutest shoes? Do you ever feel embarrassed by the way your feet look? That area next to your big toe that sticks out and makes it so those oh so cute shoes don't fit, hurt or look bad? It could be Bunions and there is help for them.
In Western countries, approximately 30% of the population live with Bunions. They are most common in women and also occur as we get older.
Bunions are more complicated than they appear. They can be painful and affect the quality of your life. Whatever the cause of Bunions, they can be addressed and there are remedies for them.
Marco Ucciferri, DPM , discusses prevention tactics as well as bunion causes, pain and the non-surgical and surgical treatments available at Summit Medical Group.
Selected Podcast
Do You Have Bunions? What Can You Do About Them?
Featured Speaker:
Dr. Ucciferri has practiced with Foot and Ankle Care Associates of New Jersey since 2003. His hospital appointments have included Hoboken University Medical Center, Somerset Medical Center, and Surgicare of Central Jersey.
Born in Italy and raised in the United States, Dr. Ucciferri says, "I became a doctor so that I can make patients feel better and help the community." He adds, "I believe in preventive health care to preempt problems before they happen."
Dr. Ucciferri is a member of the American Podiatric Medical Association and New Jersey Society of Podiatric Medicine. He is a fellow of the American College of Foot and Ankle Surgery.
Marco Ucciferri, DPM
Marco Ucciferri, DPM, expertise includes child, adolescent, and adult foot and ankle medicine, foot and ankle trauma, and reconstructive surgery.Dr. Ucciferri has practiced with Foot and Ankle Care Associates of New Jersey since 2003. His hospital appointments have included Hoboken University Medical Center, Somerset Medical Center, and Surgicare of Central Jersey.
Born in Italy and raised in the United States, Dr. Ucciferri says, "I became a doctor so that I can make patients feel better and help the community." He adds, "I believe in preventive health care to preempt problems before they happen."
Dr. Ucciferri is a member of the American Podiatric Medical Association and New Jersey Society of Podiatric Medicine. He is a fellow of the American College of Foot and Ankle Surgery.
Transcription:
Do You Have Bunions? What Can You Do About Them?
Melanie Cole (Host): Bunions are bony protuberance at the base of the big toe. In western countries, approximately 30 percent of the population live with bunions and they’re most common in women and also can get worse as we get older. They’re more complicated than they appear in many instances. My guest is Dr. Marco Ucciferri. He’s a podiatrist with Summit Medical Group. Welcome to the show, Dr. Ucciferri. Tell us a little bit about bunions. I have bunions myself and I know how painful they can be. What actually is a bunion? Is it tissue? Is it bony? What can we do about it?
Dr. Marco Ucciferri (Guest): Bunions are a deformity that patients inherit. It’s a genetic deformity that patients have that create painwith shoe gear. Many patients who have bunions who wear appropriate shoes don’t have pain, but patients who have very small bunions can have significant pain even with dress shoes or even sneakers. Basically, a bunion is the deformity of the first metatarsal which is the long bone in your foot near the big toe. The protrusion of bone increases as time goes on. Patients will usually start out with a small bump on the side of the foot. As they get older, the bump gets larger and larger and sometimes can become symptomatic. It’s a bony deformity with some soft tissue formation to the area.
Melanie: Well, I certainly know the pain of wearing dress shoes. Boy, at the end of the night, that is one painful situation. Aside from not ever wearing heels or dress shoes, what can we do about these? Are orthotics the answer? Is wearing sensible shoes all of our lives the answer? What can we do before we discuss surgical intervention?
Dr. Ucciferri: Well, basically, before you do surgical intervention, you definitely want to, if you can, change the shoes you wear. Many women will try to do that to the best of their ability especially patients who are in business. It’s hard to wear comfortable shoes because they wear dress shoes all day. That becomes an issue. Padding to the area can be helpful. Sometimes anti-inflammatories can be helpful. If there’s a day when you have to be on your feet and they get pretty sore, icing of course is helpful. Custom-mold or orthotics or a device that prevents the bunion from becoming much worse over time, but I have patients who have used custom orthotics they say it’s not gotten their bunions become worse or symptomatic as much.
Melanie: What about massage? People go for all kinds of foot massages to relieve some of the pain of their bunions, and while it hurts, it sometimes feel good to have somebody really jamming their thumb around there. Does that do anything at all?
Dr. Ucciferri: Not really. It can help with symptoms. Some patients actually can have worsening pain from massage therapy to the area, depending on how much arthritic changes are on the joint. But if it feels better, some patient say it feels better to do something like that, I would let them do it, but it does not change the actual deformity or make it go away. It could just help with the symptoms.
Melanie: Then when does surgery come involved? If this bump is genetic and it’s getting bigger as you get older and it’s really painful to wear heels for even just an hour or two—women, we all know this feeling and it’s awful—then when do we see a doctor? When do we know that we have to come see you and get something done and what is it that you’re going to do for us?
Dr. Ucciferri: I explain to patients, the most common issue that patients come in for is when it’s really affecting their daily activities. If they come in and say, “I’m not able to wear 80 percent of my shoes in my closet,” or “I stopped doing these activities such as running or stopped playing tennis or golfing because I have the pain,” when it’s affecting our daily activities and you’re just not able to get any relief from it or you’re really kind of in a swamp with trying to get improvement with the foot,, I explain to patients to give us a call. We end up initially trying to do something even sometimes a cortisone injection to the area if it’s inflamed enough to reduce some of the inflammation which can help you before you have to have surgery for that. If a patient requires surgery, it’s a very simple procedure. You could be able to heal very quickly and patients are very happy once they’re done.
Melanie: You say it’s a very simple procedure but people get afraid of any kind of surgery especially when it’s the foot because it means you’re not going to be able to walk around for a while. Do you actually slice off or remove that swollen tissue from around the big toe joint? Do you straighten it out? I mean, if their big toe is jutting towards the inside, Dr. Ucciferri, do you change that direction? Do you move the big toe so it’s pointing straight back up again? Tell us a little bit about what you actually do for us.
Dr. Ucciferri: Sure. The procedure for a bunionectomy, it is very dependent on the severity of the bunion and the type of deformity that you’re having. I explain to patients that for the most part, most patients have a common deformity that can be fixed on an outpatient basis, so typically there’s no general anesthesia associated with it, the way I do them, a little amount of sedation. It’s about a 20- to 30-minute procedure depending on the severity of the bunion, and patients are ambulatory right away. I myself do not utilize crutches for patients after the surgery. They’re able to walk on to the foot immediately. Basically what we do in a surgery, I guess it’s a 20- to 30-minute procedure where we straighten the toe, so we actually change that position of the big toe when it’s moving to the outside of the foot and we also move the first metatarsal and shift the position of first metatarsal so that the bunion is resolved and gone. It also prevents it from coming back and it also makes the toe much more functional so that when you are walking or playing sports or activities, you’re not getting soreness to the toe that you used to have before.
Melanie: Does it come back? Is there a chance that if you have bunion surgery, that all of a sudden you’re going to start to notice swelling in that same area or could it come back in a little bit different area?
Dr. Ucciferri: It can. It’s very dependent on the procedure chosen to reduce the bunion deformity. Sometimes if the procedure is not appropriate for the deformity that you have, it can return. If you have a very large deformity, you don’t quickly do a very simple procedure; you have to do a little bit more complex of a procedure. The physician should know which procedure to pick for that person and that deformity based on the presentation and that really can alleviate you having to have the return of the bunion deformity come back. A lot of times, in previous patients who I’ve seen in the past, they just have the bump taken off and those patients are not having the bunion come back. There are things that need to be done to prevent that bunion from coming back in appropriate fashion.
Melanie: Tell us about some lifestyle, things that people can do at home. Bunion pads, you see those at the pharmacy, or an ice pack or even the type of shoe, if you’re looking at shoes, Dr. Ucciferri, with the wide deep toe box. Do any of those kinds of things help to deal with bunions before we’d have to go in for surgery?
Dr. Ucciferri: Yeah. Basically the symptoms of a bunion, the pain and the soreness that you get from a bunion, are very much shoe-based. I always tell my patients, “If you can wear soft buffs around, then you wouldn’t have pain for bunion, but if you could wear a wider toe box padding to the area.” There’s some padding over-the-counter in a drugstore that can pad the area to offer pressure. I think utilizing sometimes anti-inflammatory to reduce the inflammation to the area. Those are all things that you can do to kind of prevent the symptoms from occurring, but it is very much a deformity with symptoms that are based on shoe gear. Everyone’s a little different, I explain to the patients, wear the shoes they are most comfortable. That’s why we’re going to try to keep you out of trouble with that.
Melanie: Do pointy toe shoes contribute more? As shoes get more pointy and more sharp at the ends and the heels get evermore high, does that start to cause trouble in addition to bunions? Then are those shoes pushing us forward causing other problems along the way?
Dr. Ucciferri: Yes. Any type of heel or a pointed shoe can obviously press on that bunion and cause more pain and discomfort. Not necessarily an issue in regards to causing a bunion, it can make the bunion get worse, but not cause a bunion. Like I said, the bunion is congenital. Shoes can make the symptoms much worse, not so much the deformity. I explain to patients that wearing shoes that way, to offload pressure to that area, is going to be the most beneficial thing to do. When you’re having bunion pain, it can cause you to walk differently which you become having other pains in your knees, your hips or your back. Those are things that can occur from having painful bunions with shoes that are not really accommodative of the bunion deformity.
Melanie: If you would give the listeners your best advice, if someone came up and just asked you “what can I do about my bunions,” give your best advice about shoes and home remedies. I sense such that we can do and why they should consider coming to Summit Medical Group for their foot care.
Dr. Ucciferri: Sure. When a patient comes in or when a patient approaches me about bunions, I basically explain to them, try to wear shoes that are accommodative of the bunion if you can. When it gets to the point where it’s really affecting the daily activity that you like to do such as exercising or walking or wearing the shoes that you’d like to wear, then that’s when we come in to play and we can go ahead and fix the bunion deformity. I explain to patients, “You shouldn’t be afraid to get it done.” There are many horror stories out there, but there are actually very good results from doing appropriate bunion surgery on a patient and a lot of new techniques have come out, had made it so that you could become very ambulatory very quickly, and that’s something that patients are very happy with because many patients don’t have the ability to stay off their feet for months on end. I explain to patients, “Do the right things, wear appropriate shoes, if you have to ice it, or anti-inflammatories are helpful in the meantime, but if it becomes very symptomatic and more chronic, then just call. Call us at Summit Medical Group and we can definitely go ahead and help you out. Even if it’s not even surgical, we can talk about it and go over the progression of the bunion deformity itself.”
Melanie: Thank you so much, Dr. Ucciferri. Great information! For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. You’re listening to SMG Radio. This is Melanie Cole. Thanks so much for listening.
Do You Have Bunions? What Can You Do About Them?
Melanie Cole (Host): Bunions are bony protuberance at the base of the big toe. In western countries, approximately 30 percent of the population live with bunions and they’re most common in women and also can get worse as we get older. They’re more complicated than they appear in many instances. My guest is Dr. Marco Ucciferri. He’s a podiatrist with Summit Medical Group. Welcome to the show, Dr. Ucciferri. Tell us a little bit about bunions. I have bunions myself and I know how painful they can be. What actually is a bunion? Is it tissue? Is it bony? What can we do about it?
Dr. Marco Ucciferri (Guest): Bunions are a deformity that patients inherit. It’s a genetic deformity that patients have that create painwith shoe gear. Many patients who have bunions who wear appropriate shoes don’t have pain, but patients who have very small bunions can have significant pain even with dress shoes or even sneakers. Basically, a bunion is the deformity of the first metatarsal which is the long bone in your foot near the big toe. The protrusion of bone increases as time goes on. Patients will usually start out with a small bump on the side of the foot. As they get older, the bump gets larger and larger and sometimes can become symptomatic. It’s a bony deformity with some soft tissue formation to the area.
Melanie: Well, I certainly know the pain of wearing dress shoes. Boy, at the end of the night, that is one painful situation. Aside from not ever wearing heels or dress shoes, what can we do about these? Are orthotics the answer? Is wearing sensible shoes all of our lives the answer? What can we do before we discuss surgical intervention?
Dr. Ucciferri: Well, basically, before you do surgical intervention, you definitely want to, if you can, change the shoes you wear. Many women will try to do that to the best of their ability especially patients who are in business. It’s hard to wear comfortable shoes because they wear dress shoes all day. That becomes an issue. Padding to the area can be helpful. Sometimes anti-inflammatories can be helpful. If there’s a day when you have to be on your feet and they get pretty sore, icing of course is helpful. Custom-mold or orthotics or a device that prevents the bunion from becoming much worse over time, but I have patients who have used custom orthotics they say it’s not gotten their bunions become worse or symptomatic as much.
Melanie: What about massage? People go for all kinds of foot massages to relieve some of the pain of their bunions, and while it hurts, it sometimes feel good to have somebody really jamming their thumb around there. Does that do anything at all?
Dr. Ucciferri: Not really. It can help with symptoms. Some patients actually can have worsening pain from massage therapy to the area, depending on how much arthritic changes are on the joint. But if it feels better, some patient say it feels better to do something like that, I would let them do it, but it does not change the actual deformity or make it go away. It could just help with the symptoms.
Melanie: Then when does surgery come involved? If this bump is genetic and it’s getting bigger as you get older and it’s really painful to wear heels for even just an hour or two—women, we all know this feeling and it’s awful—then when do we see a doctor? When do we know that we have to come see you and get something done and what is it that you’re going to do for us?
Dr. Ucciferri: I explain to patients, the most common issue that patients come in for is when it’s really affecting their daily activities. If they come in and say, “I’m not able to wear 80 percent of my shoes in my closet,” or “I stopped doing these activities such as running or stopped playing tennis or golfing because I have the pain,” when it’s affecting our daily activities and you’re just not able to get any relief from it or you’re really kind of in a swamp with trying to get improvement with the foot,, I explain to patients to give us a call. We end up initially trying to do something even sometimes a cortisone injection to the area if it’s inflamed enough to reduce some of the inflammation which can help you before you have to have surgery for that. If a patient requires surgery, it’s a very simple procedure. You could be able to heal very quickly and patients are very happy once they’re done.
Melanie: You say it’s a very simple procedure but people get afraid of any kind of surgery especially when it’s the foot because it means you’re not going to be able to walk around for a while. Do you actually slice off or remove that swollen tissue from around the big toe joint? Do you straighten it out? I mean, if their big toe is jutting towards the inside, Dr. Ucciferri, do you change that direction? Do you move the big toe so it’s pointing straight back up again? Tell us a little bit about what you actually do for us.
Dr. Ucciferri: Sure. The procedure for a bunionectomy, it is very dependent on the severity of the bunion and the type of deformity that you’re having. I explain to patients that for the most part, most patients have a common deformity that can be fixed on an outpatient basis, so typically there’s no general anesthesia associated with it, the way I do them, a little amount of sedation. It’s about a 20- to 30-minute procedure depending on the severity of the bunion, and patients are ambulatory right away. I myself do not utilize crutches for patients after the surgery. They’re able to walk on to the foot immediately. Basically what we do in a surgery, I guess it’s a 20- to 30-minute procedure where we straighten the toe, so we actually change that position of the big toe when it’s moving to the outside of the foot and we also move the first metatarsal and shift the position of first metatarsal so that the bunion is resolved and gone. It also prevents it from coming back and it also makes the toe much more functional so that when you are walking or playing sports or activities, you’re not getting soreness to the toe that you used to have before.
Melanie: Does it come back? Is there a chance that if you have bunion surgery, that all of a sudden you’re going to start to notice swelling in that same area or could it come back in a little bit different area?
Dr. Ucciferri: It can. It’s very dependent on the procedure chosen to reduce the bunion deformity. Sometimes if the procedure is not appropriate for the deformity that you have, it can return. If you have a very large deformity, you don’t quickly do a very simple procedure; you have to do a little bit more complex of a procedure. The physician should know which procedure to pick for that person and that deformity based on the presentation and that really can alleviate you having to have the return of the bunion deformity come back. A lot of times, in previous patients who I’ve seen in the past, they just have the bump taken off and those patients are not having the bunion come back. There are things that need to be done to prevent that bunion from coming back in appropriate fashion.
Melanie: Tell us about some lifestyle, things that people can do at home. Bunion pads, you see those at the pharmacy, or an ice pack or even the type of shoe, if you’re looking at shoes, Dr. Ucciferri, with the wide deep toe box. Do any of those kinds of things help to deal with bunions before we’d have to go in for surgery?
Dr. Ucciferri: Yeah. Basically the symptoms of a bunion, the pain and the soreness that you get from a bunion, are very much shoe-based. I always tell my patients, “If you can wear soft buffs around, then you wouldn’t have pain for bunion, but if you could wear a wider toe box padding to the area.” There’s some padding over-the-counter in a drugstore that can pad the area to offer pressure. I think utilizing sometimes anti-inflammatory to reduce the inflammation to the area. Those are all things that you can do to kind of prevent the symptoms from occurring, but it is very much a deformity with symptoms that are based on shoe gear. Everyone’s a little different, I explain to the patients, wear the shoes they are most comfortable. That’s why we’re going to try to keep you out of trouble with that.
Melanie: Do pointy toe shoes contribute more? As shoes get more pointy and more sharp at the ends and the heels get evermore high, does that start to cause trouble in addition to bunions? Then are those shoes pushing us forward causing other problems along the way?
Dr. Ucciferri: Yes. Any type of heel or a pointed shoe can obviously press on that bunion and cause more pain and discomfort. Not necessarily an issue in regards to causing a bunion, it can make the bunion get worse, but not cause a bunion. Like I said, the bunion is congenital. Shoes can make the symptoms much worse, not so much the deformity. I explain to patients that wearing shoes that way, to offload pressure to that area, is going to be the most beneficial thing to do. When you’re having bunion pain, it can cause you to walk differently which you become having other pains in your knees, your hips or your back. Those are things that can occur from having painful bunions with shoes that are not really accommodative of the bunion deformity.
Melanie: If you would give the listeners your best advice, if someone came up and just asked you “what can I do about my bunions,” give your best advice about shoes and home remedies. I sense such that we can do and why they should consider coming to Summit Medical Group for their foot care.
Dr. Ucciferri: Sure. When a patient comes in or when a patient approaches me about bunions, I basically explain to them, try to wear shoes that are accommodative of the bunion if you can. When it gets to the point where it’s really affecting the daily activity that you like to do such as exercising or walking or wearing the shoes that you’d like to wear, then that’s when we come in to play and we can go ahead and fix the bunion deformity. I explain to patients, “You shouldn’t be afraid to get it done.” There are many horror stories out there, but there are actually very good results from doing appropriate bunion surgery on a patient and a lot of new techniques have come out, had made it so that you could become very ambulatory very quickly, and that’s something that patients are very happy with because many patients don’t have the ability to stay off their feet for months on end. I explain to patients, “Do the right things, wear appropriate shoes, if you have to ice it, or anti-inflammatories are helpful in the meantime, but if it becomes very symptomatic and more chronic, then just call. Call us at Summit Medical Group and we can definitely go ahead and help you out. Even if it’s not even surgical, we can talk about it and go over the progression of the bunion deformity itself.”
Melanie: Thank you so much, Dr. Ucciferri. Great information! For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. You’re listening to SMG Radio. This is Melanie Cole. Thanks so much for listening.