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2. Types of Bunion Treatments

A variety of conservative treatments for bunion pain relief and big toe correction promises to either postpone the need for surgery or avoid a bunionectomy altogether. Every patient is different in the degree of metatarsophalangeal (MTP) joint deviation from the big toe (stages of a Hallux valgus) and/ or their compliance (how frequently and for how long they use the treatment). Doctors and patients are known to have prescribed or used any one orthotic solution or a combination of solutions ranging from toe spacers or pads to night time splints – all with different outcomes.

1. Protective pads or cushions such as pre-cut pads and gel toe shields and caps simply protect the bunion from friction but do not straighten the big toe.

2. Toe spreading devices take the form of a wedge being positioned in the space between the big toe and 2nd toe, so the big toe is pushed towards the inner side of the foot. Unfortunately, in order to exert a force, they support themselves against the neighboring toes, causing incorrect position of those toes 5.  However, toe spreaders, such as Yoga Toes®, which insert spread between all five toes tend to provide a consistent and comfortable positioning of the toes.
 
3. Toe straighteners are usually padded splints that run along the inner side of the foot as a spring with a ring eye at the toe end to hold the big toe. At the other end, the pad splint is bent to rest against the heel allowing the big toe to be brought out into normal position. Compliance can be difficult due to the discomfort of these contraptions 6.

4. Bunion splints or braces, with compliance, are the most effective conservative treatments in preventing further progression of a bunion, as well as for post-operative purposes. Well designed splints address the underlying foot function that contributes to the toe deviation, whereas, the aforementioned treatments do not.

 

About bunion splints

The basic design of a bunion splint has a “holder” for the
big toe, extended in a longitudinal direction connected to
another “binding” around the mid-foot, resulting in a corrective force of the big toe (7). The most successful splints address the underlying foot function by providing proper support to the midfoot’s two arches (longitudinal and transverse) while pulling the big toe away from the 2nd toe, gently stretching the tendon and toe muscles.

 

In general, bunion splints fall into two categories:

1. Rigid splints, most often, are considered night time splints
because the materials are either not flexible and/or cannot bear weight.
Custom-molded rigid splints are made of thermoplastic that is molded to the medial aspect of the foot and great toe.
Ready-made braces are unmolded straight splints made of
plastic or metal against which the foot and great toe are
attached.

2. Flexible or soft splints are made of fabric material that
surrounds the forefoot and great toe. Correction is by way of a strap that is attached to the brace by hook & loop fasteners or by the bias cut of the material that pulls the big toe into the corrected position. Flexible splints are most often considered day splints because of the ability to walk in them (8).

Prevent future deformity

“Orthotics should support the arches of the foot in general and the anterior transverse arch in particular. By supporting the metatarsal heads and allowing for the normal spread of the forefoot, an orthotic can reduce current symptoms and prevent future deformity.
A foot that is already developing a bunion must be provided with good support for the medial longitudinal arch. The orthotic should allow for flexibility and movement of the first metatarsal joint during the dorsiflexion required at toe-off.” (4)

Bunion Relief

Bunion Buster

In this video of the Dr. Oz Show, September 22, 2010, Dr. Oz said that splints, as a “Bunion Buster,” are quite effective.