If you have a bony outgrowth on the side of your big toe joint, you may be developing a bunion (hallux valgus). Bunions can be caused by many things, such as family predisposition, arthritis, tight shoes, and so on. If a bunion is left untreated, it can cause corns/calluses, swelling, and cartilage degeneration. Before considering surgery, your podiatrist may recommend custom orthotics. Read on to learn more about bunion orthotic options and why customized options tend to be better than over-the-counter treatments.
Why Are OTC Orthotics a Problem?
A lot of over-the-counter orthotics are meant to cushion feet and mitigate pain, but they may not correct the root issue. Over-the-counter orthotics must fit many different shoe sizes, so the arch of the orthotic doesn't hug the foot tight enough. When this happens, the arch can collapse and the first metatarsal bone — the bone behind the big toe — will retain too much pressure for the bunion to be corrected. Furthermore, because OTC orthotics don't have a snug fit on the sole of the foot, the metatarsal bone won't be supported, so patients may mitigate pressure by pushing their toe medially, which again, won't help to correct the bunion.
How Do Podiatrists Make Customized Orthotics for Bunions?
Custom orthotics conform to the arch closely, so you won't have as much pressure on the balls of your feet. In order to make these orthotics, your podiatrist might take a laser scan of your foot or take an impression of your foot. Your podiatrist may also perform a gait analysis to gain any information about biomechanical issues you may be having that are contributing to the bunion formation. Once the podiatrist has the necessary information, he or she will submit an orthotic prescription to a laboratory where technicians will make orthotics that conform snugly to your feet.
Which Types of Custom Orthotics Are Available for Bunions?
There are three basic types of full-foot orthotics: functional orthotics, semi-rigid orthotics, and accommodative orthotics. Functional orthotics and semi-rigid orthotics may be made out of stiffer materials and are intended to splint and hold the foot in a neutral position. They are often used to correct sports injuries or to correct bio-mechanical issues. Accommodative orthotics are made of softer materials — but not so soft that the arch collapses — and they are mainly used for bunions, hammertoes, calluses, and other issues that require cushioning and correction.
Your podiatrist can also prescribe custom toe sleeves or insoles with toe separators. If the skin on your big toe is chafing on a shoe's toe box, then a toe sleeve can cover the side of your toe and ease this rubbing. While insoles with toe separators won't improve bunion angles like a full accommodative orthotic, one study found that these devices were a good way to decrease pain intensity.
Reach out to a podiatrist in your area or visit a site like https://www.advancedfootclinic.org/ to learn more.