Are you afraid to go to the doctor to get your bunion checked Because you're afraid of surgery? If, so this video is for you. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, Texas. And bunions are one of the most common findings that I see in my patients of all ages. If a bunion isn't painful, I don't often recommend surgery. There are lots of conservative treatments to try first. In today's video, I'll discuss the nonsurgical, conservative treatments for a bunion. I'll also discuss the bunion correctors and pads that you may find in the foot care aisle of your pharmacy.
I found that whenever someone has foot pain, they turn to one of two places: Google and the pharmacy foot care aisle. Both of those places can be overwhelming with both good information and lots of misinformation. Let's start with the foot care aisle. Most people ask me about bunion correctors. These are devices that pull over the great toe from the second toe and push in on the bunion. Most are designed to be worn while you sleep at night. And while these do help this stretch out the soft tissue, it's not successful in bringing the bones back into alignment. Remember a bunion is a shifting of the metatarsal bone, not a growth of bone. So no matter what Dr. Google tells you about people claiming their bunion went away without surgery. It truly just doesn't happen.
Another product that you'll find is a bunion pad. This is a silicone or foam pad that fits over the bump of the bunion itself. If your pain is on the bump of the side of the great toe joint, this could be the cushioning you need to protect it while you're wearing shoes. However, sometimes adding a pad to something that's already painful, may fill up too much space, make your shoes more narrow, and it becomes more uncomfortable. There certainly is no harm in trying though. Another product that works very well is a toe separator or spreader. This is a silicone or a foam pad that goes between your great toe and your second toe. Now, if your great toe is leaning over too much, and the two toes are touching and that's uncomfortable, this is the right pad for you.
Just a word about shoes. A bunion makes the front part of your foot wider, and most shoes are not made like that, with a wide forefoot and a narrow heel. You either have a wide shoe or a narrow shoe. You want to try to find the widest shoe that you can find that stays on your foot when you're walking and running. That's going to help to keep the pressure off of the bunion itself. So what about conservative treatments that we do in the office? Well of course I use and recommend bunion pads and toe separators when they're appropriate, but remember a bunion starts small and that's the best time for you to get it checked.
The bunion progresses because of the foot mechanics that you inherited from your parents or grandparents. And if we can change your mechanics and remove the forces that are causing the bunion deformity, we can slow or stop the progression of your bunion. I do that with something called a custom orthotic. A custom orthotic is a prescription shoe insert that's made specifically for you. To make an orthotic, I perform an extensive biomechanical exam to learn about the range of motion on your lower extremity. I'll also watch you walk to do a gait analysis and see how everything is just working together. Ultimately, we take a mold of your feet to send to the lab with a prescription. The goal of an orthotic is to compensate for the mechanics that you inherited, and neutralize the forces that are causing the bunion deformity to progress. An orthotic should also help if you're feeling pain deep in the joint.
Unfortunately, if you're feeling the pain on the bump of the bunion, I don't find that an orthotic is very effective. If the pain that you're feeling is at the bump of the bunion, it's because it's inflamed from rubbing against the shoe. In that case, we'll try an anti-inflammatory medication. Most effective is a cortisone injection. This drops the medicine right at the site of the inflammation. It works quickly and effectively. Other treatments include oral and topical anti-inflammatory medication. We'll also try using a bunion pad to help to lessen the pressure of the bump of the bunion against the inside of your shoe.