Reducing the pain of bunions

I’m in my 30s and have bunions, which get quite painful from time to time.

Other than surgery, is there anything I can do to improve them and reduce some of the pain they cause?

>>Bunions, as you have found, can be very painful and cause a lot of discomfort. A bunion or hallux valgus is a deformity of the joint at the base of the big toe. With adolescents or young adults there is often a family history. It is more common in females and occurs most frequently in the sixth decade of life.

It is unclear why the deformity occurs but wearing tight or badly fitting shoes tends to exacerbate the problem. The big toe is angled towards the second toe and this creates a bump on the side of the base of the big toe. The skin and tissue next to the joint can become swollen and painful when it rubs against the inside of your shoe.

Sometimes changes to your footwear can ease the symptoms, particularly the discomfort, but this does not delay the progression of the condition.

I suggest you make an appointment with your GP who can examine your feet and advise on the most appropriate treatment, which may include a referral to a surgeon.

In the meantime, here are some general suggestions to try:

* Wear shoes that fit well and have room around the toe. If you are buying new shoes ask to have your feet measured.

* Avoid wearing high-heeled shoes or shoes with pointed toes.

* Buy small pads to place over the bunion — your pharmacist will advise you.

* Try foot exercises.

* Paracetamol or ibuprofen may help to ease the pain.

I am a woman in my early 50s and recently I noticed some red / purple patches around my ankles. The skin feels dry and is itchy. I mentioned it to my mother who remembered that my grandmother had something similar and it was diagnosed as varicose eczema. There is a history of varicose veins in the family. What should I do?

>>Varicose eczema is an area of dermatitis (skin inflammation) following poor blood supply on the skin related to varicose veins.

Varicose veins are caused by increased pressure in the veins under the skin in the legs. This pressure makes it difficult for the blood to flow up through the veins in the legs the blood in the veins flows backwards which causes the swollen and enlarged veins. While the pressure inside the veins increases, it can damage the skin and cause varicose eczema.

As you have noticed, the skin colour can change and become dry, shiny and itchy. The area is usually brown due to pigmentation caused by leakage of red blood cells. The most common sites are the inner sides of both lower legs and ankles.

I would advise you to make an appointment to visit your GP who can examine your legs and make a diagnosis. The treatment of varicose eczema involves treating blood flow problems as well as skin damage.

While waiting for your appointment here are some general suggestions to consider:

* Avoid any damage to the skin by knocking against furniture or other objects.

* When you are sitting down raise your legs by either using a foot stool or lying on a sofa with a cushion under your feet.

* Avoid standing for long periods of time and walk or exercise regularly.

* It is very important to keep the skin well moisturised so that it does not dry out — the cream should be unscented. There are a number of emollients on the market and your pharmacist will be able to advise you. Please avoid long-term usage of steroid cream unless it was instructed by your doctor.

As family history is important you need to tell your GP about the family history of varicose veins and varicose eczema.


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