What Does Paul Bunyan Have to Do with Pain As You Age?

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

This month, let’s talk about foot pain, why seniors are more vulnerable, and how you can prevent it early with your shoe choices.  We know chiropractic treatment is the least expensive and quickest way to return to normal function if you have back pain. But if foot pain or bunions are present AND you have back pain, you may also need to address your shoes.

Paul Bunyan and his sidekick Babe, the Blue Ox, were characters in lumberjacks’ folklore for years before William Laughead composed a direct mail pamphlet for the Red River Lumber Company in 1916. Then, the duo became a sensation across the United States, and with his massive boots and enormous stride, Bunyan seemed unstoppable.

But anyone with the Bunion Blues will tell you that real bunions can stop you in your tracks. Today,  according to a review of the 2009 Framingham Foot Study, bunions affect  23 percent of people aged 18 to 65, and 36 percent of those older than 65.

What is a bunion? A bunion (hallux valgus) is a painful, bony bump at the base and side of the big toe. It often happens when the top of big toe is consistently pushed against the toe next to it, forcing the bottom joint to stick out. Women’s narrow-toed, high-heeled shoes are a major cause; though toe shape and arthritis can also play a role.

And seniors have more pain from the same stimulus as those who are younger, which offers another reason to change your shoes now. George Burns said it best. As he approached his eleventh decade, the great vaudeville, radio, film, and television comedian said, “I was brought up to respect my elders, so now I don’t have to respect anybody.”

But until you live to such a ripe old age, it’s a good idea to respect your elders and offer them a bit of extra attention and understanding.  That’s because in addition to being older and wiser, the elderly also have to contend with pain that’s more pronounced and lasts longer.

Researchers from the University of Florida tested the pain response of a group of volunteers (average age = 21) and an older group with an average age of 68. They found that while both groups were exposed to similar levels of pain, in older adults, levels of cytokines—immune system markers of inflammation that indicate the presence of pain—were higher and stayed elevated longer. The researchers recommend older adults should not tough it out, but treat pain early. Even better, prevent it. So here is our take on bunions…

If you have a bunion, here’s what to do: Wear more comfortable shoes. (Duh! YES, the earlier you abandon high heels, the less likely a problem that requires surgery will develop. And abandon them not just for a day, but for a while; wider shoes help too!)

Discuss treatment options with a podiatrist or other healthcare professionals. Treatment options include padding or an orthosis (corrective shoe insert), ice, ibuprofen, cortisone injection and, lastly, surgery. Osteotomy is surgery performed to realign the joint; exostectomy removes the bump.

If avoiding surgery isn’t enough of an incentive to get you to put away those stilettos (stick with 2-inch heels, or no heels, even better), taking better care of your feet can also help you dodge nerve damage, lower back pain, a shortened Achilles tendon, and sciatica, and that makes your RealAge younger not just now, but for the long term.

Thanks for reading. Feel free to send questions—to youdocs@gmail.com, and some of them we may know enough to answer (we’ll try to get answers for you if we do not know).

Young Dr Mike Roizen (aka, The Enforcer)

 NOTE: You should NOT take this as medical advice. This article is of the opinion of its author. Before you do anything, please consult with your doctor.

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have tow newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz.  These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.  And, the new book by Dr Mike Roizen: This is YOUR Do-Over

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.