Comfort level of orthotics on bunions



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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A bunion (hallux valgus) is the combination of osteoarthritis and bursitis at the base of the big toe or at the base of the little toe (in which case it is called a "bunionette" or "tailor's bunion").

Bunions often occur when the joint has been abused over a long period of time. They are nine times more common in women than in men, primarily because women may be more likely to wear tight, pointed shoes. Bunions may be inherited as a family trait.

The first step in treatment for bunions may include wearing comfortable, well-fitting footwear (particularly shoes that conform to the shape of the foot and do not cause pressure on areas that are subject to bunion development) or the use of orthotics (special shoe inserts shaped to the foot) to change the position of the big toe. For the arthritis component, anti-inflammatory medications may help reduce pain and swelling.

Orthotics are specially designed devices that are worn inside the shoe to support normal foot function and/or make room for painful areas in the foot. Well-designed foot orthotics can compensate for poor foot function by controlling abnormal motion of the foot. This can lead to dramatic improvement in foot symptoms.

Functional foot orthotics are usually made from rigid materials, especially plastics and carbon-fiber composites. They are constructed on a plaster impression of the feet, and modified based on the patient's problem. They are usually comfortable, and do not feel hard or uncomfortable in the shoe. Rigid orthotics normally last for years.

Some patients may not tolerate rigid functional orthotics. Soft orthotics may be an alternative solution. Many different materials can be utilized, such as rubber, cork, leather, and soft synthetic plastics. The type of doctor who usually fits custom orthotics is a podiatrist. The podiatrist can evaluate, diagnose, and treat foot or leg problems. Orthotics that are prescribed by the podiatrist and custom made for your feet, are different from over the counter arch supports.

That being said, many "stock" orthotics do perform well. Here's the tip: If the over-the-counter ones don't work, try a custom orthotic. More recently, there are running shoe shops that offer a custom orthotic and these are another option to try.


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