Patients that present to my office with bunion pain tend to present with two uniquely different kinds of pain. The first type of pain is no more complex than the simple square peg-round hole phenomenon. The foot, with the prominent bunion becomes the square peg that can no longer fit into the shoe, or round hole. The second kind of bunion pain is a bit more common and is what really brings most folks to the office. This second type of pain is a dull achy sensation in the joint that is the result of the joint functioning in an altered or deviated position. This pain is deep in the joint and tends to last long after the shoe is removed. So when we speak of bunion pain, let’s try to address each of these types of pain as two unique types of pain.
When we speak of conservative care for the first type of pain (square peg/round hole) we can use bunion padding or we can make the round hole larger (shoe modifications). Myfootshop.com carries a number of pads used to treat this particular bunion pain. They include a gel bunion pad, foam bunion pad or even a cut-out felt bunion pad. All are used to protect the foot from the direct pressure applied to the foot from the shoe. And remember, it’s important to spot stretch the shoe whenever possible.
And the second type of pain? The arthritic type of pain? When treating this second type of pain, I will suggest bunion pads that are used to straighten the toe. Now bear in mind, straightening the toe is not intended to correct the bunion. The toe is merely straightened to relieve pain. The deviation of the great toe found in a bunion deformity will never be corrected with anything short of surgery. But when using a pad to treat this second type of pain, we use two categories of pads; ambulatory pads/splints and splints used at night. Ambulatory pads can be a foam wedge placed between the toes, gel pads or splints. My favorite is typically a firm gel toe straightener. It’s inexpensive and easy to use. The classic nighttime splint is something called a bunion regulator. But remember, bunion regulators are a non-ambulatory splint. We’d recommend this splint most often as a post-op splint to maximize correction of the surgery.
But do these pads really works? Yes and no. Yes, the pads can help with day to day pain. But no, they’re not going to correct the bunion. What’s most important is knowing what causes the pain you have with your bunion and how it’s best treated with each of these padding choices.
Jeffrey A. Oster, DPM