Bunion with toes clawing. Picture: Wiki.
Bunion treatment is one of those problems where everybody has got a solution but unfortunately they are "old wives tales".
It is a widely debated and controversial subject because what works for one person, doesn't always work for another.
You have to look at the foot not as a simple structure but as a very sophisticated and complicated structure that has many moving parts which are hidden within the foot and ones that exert actions on the foot but are not within it.
It is flowery words above, but that is the best description. You have small bones, small ligaments, small muscles and large muscles that live on the leg and a design that allows you to walk without pain and without excess pressure building up.
With that in mind, the following treatment options can be viewed upon with great care.
Surgery for big toe joint problems is a very difficult area to recommend because in our experience 50% of people who have a surgical treatment comes out great, whilst 50% come out worse.
There are over 100 different surgical techniques available to surgeons and each one is dependent upon the patient activity, patient health and patient benefit.
For instance there are ones that just remove the bone lump off the side of the toe. In this case the lump is going to grow back in time so it is limited to elderly patients.
Other surgeries re-align the toe, remove the bony lump and figure out the cause. in this case it would be more likely to be used by a younger patient.
Bone fuses are permanent surgeries that totally immobilize the toe. Sometimes clawed toes are fused or straightened, but this can lead to pressure because they can not move or be moved.
Surgical options can only be discussed with a qualified surgeon. No-one apart from a surgeon can tell you otherwise. Make sure the surgeon is qualified and has done this type of surgery many, many times and is versed in prevention.However, a good surgeon will always give you alternative methods to try because of the 50/50 risk.
Also they will tell you what to expect and how long you will be off your feet for- it's not a day, even if the surgery is a day case.
Update. There is a new surgical procedure that has come out. A very small cut is made and then a drill is used to mush the bone where needed. The mush is then squeezed out of the cut. Healing times reduce, no need for hospital shoes and patients seem to like it. The only problem is that there should be a need to reduce the issues that caused the bunion in the first place rather than treating the bone issues.
Can you cope just by getting a wider/ deeper pair of shoes and lay off the heels? Some people can some want to keep their heels...but if your big toe joints are hurting then heels just make the issue worse.
These should be given by an experienced Chiropodist and they can slow down the formation of bunions by addressing the causes- excessive pronation, if you have it. They can not however stop bunions and can not bring feet back to normal. As a side note, if you are able, orthotics should be given to all able patients once they have had their surgery because of the effect of the orthotic to slow down bunion progression.
These type of treatment methods get a lot of press and I am unsure why. Sure they help relieve pressure but there are a couple of problems:
1. You need to get the "hole" of the pad in the right area or else it makes to bunion pain worse.
2. Pads actually make, just slightly, your shoes tighter- making rubbing more likely.
3. You don't want to stick something on your toes all the time. This causes the skin to dry and become damaged.
4. The devices can move about quite easily, moving past the big toe joint and causing pain.
If you need pads, then you can see the need to remove pressure from the area- get yourself a pair of wider and deeper shoes.
Bunion Regulators, Toe Brace, Bunion Devices.
Let's jump in here right away, they don't work. Having a device that moves your big toe gently in the opposite direction is a gross blindness to the instigator of bunions- muscles. You see once excessive pronation sets up your foot, the muscles take over- they become imbalanced and pull your toe over- the more you walk, the more you exercise the more the powerful muscles tug onto your toe. The gap left simplistically is filled by bone- your bunion.
There is no way that a device can go against your muscles and no way that just leaving it on at night time can sort out a mechanical problem. Also if you are not wearing orthotics then the brace is useless anyway. If you refuse to give up heels, the brace is useless. Don't waste your money.
Once you do have a bunion, prevention and minimizing is the key, doing everything before a surgical procedure is sometimes much better than surgery, unless your toe is interfering with daily life.
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