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Sometimes you just have to do what you have to do. When you have a bunion the advice that podiatrists are going to give you are going to be to make sure that your footwear is of an adequate width in the forefoot so as not to push on the bunion or push the big toe over further. You will probably get some advice on some exercises that you could do to help keep the toe mobile and flexible. You will be given some education about the cause of the bunion being a combination of hereditary factors and poor fitting footwear and the importance of getting the right footwear for a better long term outcome. You may even get admonished at a follow-up visit if you are not following the advice. There may also be a discussion of different types of pads that can be used to relieve pressure over the bunion and different ones that you can wear in your shoes to make them more comfortable if they are painful. You will probably have a discussion about the surgical options for bunions and how different surgical techniques can be done and just what is the recovery time following bunion surgery.

But sometimes (or maybe often) you find yourself in a position where you have to wear or use the shoes that you have just been told are not good for your bunions, or even worse, you have to wear tight fitting footwear for some sort of special occasion. The world is not going to end if you do that occasionally, but it is going to be a problem for your bunion if you do it a lot. What can you do if you find yourself in that position and need something to get you through to help protect the foot and maybe even prevent future problems? There are some options that maybe you might want to try to help you get through the very short term use of the wrong footwear. One of these products that we often advise patients to use is the Bunion Assassin or similar products. These are a sleeve that goes around the forefoot and between the first and second toe. In between the toes it has a silicone pad that puts a gentle separation between the toes to put it in a more correct position. It also has some silicone gel that goes over the bunion to protect it from shoe pressure to make it more comfortable. The Bunion Assassin is not going to fix your bunion, it is however, going to make it more comfortable and perhaps make those shoes that you really should not be wearing more tolerable. Additionally, if you do end up wearing those wrong shoes very occasionally, you could consider the bunion corrector night splint that will go a little way to undoing some of the damage that the shoe might have done. Also after a night out in those wrong shoes you know you should not be using, do some exercises to mobilise the joint.

Sometimes the terms that get used medically, hallux valgus (or hallux abducto valgus) and bunions are used to describe the same thing when they aren’t.

A bunion is the enlargement that occurs on the big toe (hallux) joint, or technically the first metatarsophalangeal joint. Hallux valgus is when the big toe angles in a valgus direction, which is towards the outside. There is debate about if this is valgus or abductus (hence the term hallux abducto valgus and which one occurs in which direction, but that can wait for another day).

Basically, a bunion is the lump and the hallux valgus is the deformity.

So, yes they are not the same thing, but a bunion almost always occurs with a hallux valgus and they are both parts of the same problem.

These are splints or braces that you are supposed to wear at night and are claimed by those who sell them to correct the bunion (or more appropriately called ‘hallux valgus’). If you look at the pictures of them, it is easy to see how they might do that. The question then becomes, do bunion correctors work?

Thinking about the physics and biomechanics, it is easy to see how the brace could try to correct the position of the toe during the night. The only problem with that thought is that the next day you have all the forces of weightbearing and the footwear pushing the toe back the other way. It is probably likely that those forces easily overcome any correction that may have occurred over night, at least theoretically.

What does the actual evidence say? One study has shown that they do actually work. They showed an improvement of a few degrees after a few months of use, which seems a good outcome. However, what the study did not show (and no other study has looked at) is that if there is any more improvement if it is used for longer or if the improvement is maintained if use of the bunion corrector is stopped. Based on this it is hard to give advice on if the bunion correctors do work at improving the angle of the big toe. That does not stop a lot of people asking if they work in forums and Q & A groups online.

Having said that, that does not mean that they do not have there uses. However, that use often has to be combined with the use of exercises and footwear advice. They can be particularly helpful at increasing the mobility of the joint and that can have a significant impact on the ‘aches and pains’ coming from inside the joint that can be common in those with bunions. We do have these available if you think you would benefit from them and please do not hesitate to contact us if you have any issues with bunions.