As many of you may have seen, Dr. Oz included bunion surgery as a topic of his show on October 30, 2013. He featured Marilyn Milian, a celebrity judge from the show “The People’s Court.”
Dr. Oz first discussed the risk factors for bunion deformities, which he said are high heel shoes with a tight toe box, genetics, and arthritis. These are all contributing factors, but the underlying cause he left out is the role of biomechanics. The precise movement of your bones as you walk ultimately decides if you will form bunions. This means you are not necessarily doomed to form bunions just because your parents have them. Saying bunions are genetic is only true to the extent that you may inherit the same biomechanical patterns as your parents that could eventually lead to bunions, but this can be corrected well before a bunion develops by simply wearing an orthotic. Podiatrists are trained to spot and correct these biomechanical abnormalities. Unfortunately, most people don’t find a reason to visit a podiatrist until the bunion deformity has already begun, which explains why bunion surgery is now so common.
The next piece of Dr. Oz’s presentation may have been misleading to the average viewer not accustomed to the vast diversity of bunion procedures. There are over 100 different ways a podiatrist can surgically correct a bunion, and the 2 methods Dr. Oz highlighted did not match the pain level Marilyn Milian described. Dr. Oz started off by showing a digital representation of an Austin bunionectomy, where the podiatrist will cut out a wedge of bone at the end of the first metatarsal, shift it over toward the second toe and screw it in place. Although it looks gruesome, the recovery for an Austin is not bad. The patient can walk immediately after surgery with the use of a boot (Marilyn said she rolled around on a scooter for the first few weeks after her operation). Also, Austin bunionectomy patients are usually back to high impact activity (like running) after 2 months. Marilyn is at her 2 month mark and still in a boot. This means Marilyn either had some unusual complications, or the more likely option is that she had a more debilitating procedure done.
The second operation highlighted by Dr. Oz involved the use of the gigantic foot model. Although this also looks gruesome, this procedure has an even shorter/easier recovery period than the Austin, so it was misleading for Dr. Oz to saw through the bone model and then ask Marilyn, “was it worth it?” This is because a Silver bunionectomy not only allows the patient to walk immediately after surgery, but it only requires 10-14 days in a post-op shoe with a return to normal shoes by 2 weeks. It is a vastly different recovery than what Marilyn is experiencing.
While nothing Dr. Oz said was necessarily untruthful, the order in which the information was presented was misleading and should not deter you from seeking treatment for your bunions. A podiatrist is well-trained to assess the patient as a whole and find the best surgical option (if surgery is even necessary at all). Each procedure falls on a spectrum ranging from minimal pain and short recovery to higher pain and longer recovery similar to what Marilyn Milian is experiencing. The tradeoff is that the higher you go on that spectrum, the better the result will be in the long run. Many of the less invasive procedures do not correct the bunion at the level of the deformity, meaning it may require another operation down the road. Also keep in mind that bunions always get worse over time, so it is best to intervene early. Lastly, there is no guarantee with any operation, and each patient will respond and recover a little differently. While pain is expected with any major surgery, it can be managed, and in most cases a few weeks of pain outweighs the lifetime of pain a bunion may cause. If you would like to be evaluated, please make an appointment with one of our podiatrists at Affiliated Foot and Ankle Center located in Howell, NJ.
By Hal Ornstein