Bunions more common in women

New research has found that an increase in the severity of bunions not only increased foot pain and impaired mobility, but also affected people's general health and quality of life.

Bunion deformity was found in 36% of the study sample. It occurred more frequently in women and older individuals. The study also found that pain in other parts of the body beyond the foot was associated with increased bunion severity.

Associate Professor Hylton Menz of La Trobe University in Melbourne, Australia, and colleagues at the Arthritis Research UK Primary Care Centre, Keele University examined the prevalence of and factors associated with hallux valgus – bunions.

The Medical Research Council funded study assessed the severity of deformity on general and foot-specific Health Related Quality of Life (HRQOL) of 2,831 people aged 56 years or older in North Staffordshire.

The research team established five severity grades of hallux valgus, corresponding to the angle of deformity - from 0, 15, 30, 45, and 60 degrees.

Results showed that the impact of increasing hallux valgus severity on HRQOL is independent of age, sex, education, body mass index, and pain in other parts of the body.

They also revealed that impact of bunion extends beyond pain and physical function to affect general health, vitality, social function, and mental health.

"Our findings indicate that hallux valgus is a significant and disabling musculoskeletal condition that affects overall quality of life," concluded Associate Professor Menz.

"Interventions to correct or slow the progression of the deformity offer patients beneficial outcomes beyond merely localised pain relief."

Hallux valgus is a common foot condition that is caused when the big toe bends in towards the smaller toes. It develops over time and is accompanied by a painful soft tissue and bony protrusion, known as a bunion.

As the deformity progresses the lateral displacement of the hallux (big toe) begins to interfere with normal alignment and function of the smaller toes, leading to further deformities such as hammer toe or claw toe, altered weight-bearing patterns, and the development of corns and calluses.

Family history, wearing high-heeled shoes or shoes that are too narrow, and flat footedness have all been suggested to contribute to the development of bunions.

Details of this UK population-based study appear in the March issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

(Source: La Trobe University: Arthritis Care & Research)

Foot Pain? You may have diabetes

Do you ever feel burning, tingling or numbness in your feet and toes? The American College of Foot and Ankle Surgeons (ACFAS) warns against ignoring these symptoms. They could be a warning sign of diabetes.

Foot and ankle surgeons say those symptoms may be caused by a condition called diabetic peripheral neuropathy, or nerve damage. Neuropathy in the feet can lead to permanent numbness, deformities such as bunions and hammertoes, and dry skin that cracks open and won't heal.

"Diabetic peripheral neuropathy is not only painful but dangerous," says Boston foot and ankle surgeon John M. Giurini, DPM, FACFAS, president of the 6,000-member surgeons' association. "It's a leading contributor to foot ulcers in people with diabetes."

Burning, tingling and numbness in the toes can also be symptoms of thyroid problems, nutritional deficiencies, back problems and pinched nerves in the ankles. In the United States, diabetes is the leading cause of peripheral neuropathy and can lead to further foot complications.

Out of the 23 million Americans with diabetes, one in four hasn't been diagnosed. Some people learn they have diabetes only after seeing a doctor for burning, tingling and numbness in their toes and feet. Many people already diagnosed with diabetes aren't familiar with neuropathy's symptoms. According to FootPhysicians.com, even diabetic patients who have excellent blood sugar control can develop diabetic neuropathy.

Medications can treat neuropathy pain. But nerve damage cannot be reversed.

"When you have diabetes, and especially diabetic neuropathy, a minor cut on your foot can turn into a catastrophe," says Giurini. "The statistics on diabetic ulcers are sobering."

Twenty percent of diabetes patients who develop ulcers will require an amputation. Patients who are black, Hispanic and Native American are twice as likely as whites to need a diabetes-related amputation. Half of all people with diabetes who have a toe or foot amputation die within three years. The annual cost for diabetic ulcer care in the U.S. is estimated at $5 billion.

(Source: The American College of Foot and Ankle Surgeons: October 2008)