As podiatrists, we are constantly asked why correction devices such as the one pictured above are not recommended or offered as part of a treatment plan.
They are marketed quite heavily on social media and seem to have amassed quite a following, however, they continue to pose the question – do they really work?
Firstly, let’s have a little refresher.
What are bunions?
Bunions are a progressive and complex problem occurring at the big toe joint. Put simply, the big toe drifts towards the second toe and a ‘bump’ forms at this position on the big toe. We call this hallux abductovalgus, or HAV. It often causes the toe next to it (the 2nd digit) to attempt to move out of the way and a hammer toe deformity arises.
Bunions are quite easy to diagnose, as they are bony deformities that can be seen and identified immediately. Often, we will send you for scans (usually an X-ray) to determine the number of things including the severity of the bunion and the degree of deterioration/degenerative of the big toe joint.
When diagnosing a bunion, we generally break it down into 4 stages. The treatment of each stage differs slightly.
Stage 1 – This is the beginning of a bunion. This is a noticeable lump now present at the base of the big toe.
Stage 2 – This is when the bunion will progress to drifting towards the 2nd toe. At this stage, we may see a slight retraction of the 2nd toe, meaning it may “stick up” a little and begin to look like a hammer toe. The toe will be moving into more of an abducted position, meaning that it will begin moving outwards away from the midline of the body.
Stage 3 – The bump of the big toe becomes larger and the 2nd toe becomes more affected. The gap that is usually present between the 1st and 2nd toes generally closes up and the big toe is pressed against the 2nd toe. This is where we tend to see corns, callus and ingrown toenails develop between the toes and on top of the 2nd toe.
Stage 4 – This is where there is overlapping of the 1st and 2nd toes. The big toe has now progressed to the point where the 2nd toe must try and move even further out of the way. We may also see deformities of the 3rd and 4th toes at this stage and they too are moved out of alignment.
So, do these corrective devices really work?
Whilst many companies claim that these devices correct bunions, the research does not agree. There are a number of articles and sites online that claim that these deformities can be corrected without surgery through the use of splints, padding, shoe modifications and exercises.
However, the truth of it is that these modalities simply work to help to reduce your symptoms, not physically correct the deformity. They are bony deformities occurring in adults where the bones have set in place over time.
A recent study conducted in 2020 concluded that of the 70 participants, none of them experienced a significant change in the hallux valgus angle (the degree of deformity) (1). However, it did find that those who consistently used a ‘corrective’ device experienced less pain during walking and running.
Other studies have concluded that these devices do not address the underlying cause of the bunion and are therefore unlikely to provide the correction. If the bunion is flexible or in its early stages (stage 1), these devices may help to slow the progression. However, given its nature as a progressive condition, they may not be able to stop them completely and once you remove the device, the toe will fall back into its original alignment.
These devices may actually be more painful if there is arthritis present in the joint. The joint will be somewhat immobile and placing further pressure on it may cause more problems than it fixes.
Casting and splinting tend to work better in children with various deformities as their bones have no set and are more pliable, meaning that they can essentially be moulded into a different position without surgery.
Why should you see a podiatrist?
Podiatrists are foot health experts and are well-versed in the management and treatment of bunions. Before you purchase these devices, we recommend consulting a podiatrist for a thorough assessment because there may just be other ways we can help to reduce your pain. And no, that does not always mean surgery!
Final Message from our Podiatrists
These devices may help to manage your pain, however, they are highly unlikely to correct the position of your toe. Come and see us first so that we can help create a tailored management plan to help manage your bunion pain!
- Plaass, C., Karch, A., Koch, A., Wiederhoeft, V., Ettinger, S., Claassen, L., … & Stukenborg-Colsman, C. (2020). Short term results of dynamic splinting for hallux valgus—A prospective randomized study. Foot and Ankle Surgery, 26(2), 146-150.