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Do orthotics stop bunions?

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Hello Dr. Abrams. Thank you for this service. In your experience as a podiatrist, do custom orthotics slow or stop the progression of bunions and tailor’s bunions? Can you give me a percentage of cases you have seen where the bunion growth is arrested?
I ask this because I went to a podiatrist six months ago who said that my beginning bunions and tailor’s bunions were caused by biomechanical problems (he said I had forefoot varus and equinus). He recommended custom orthotics and physical therapy, which I did. Unfortunately, I started traveling, then moved, and was never able to get the adjustments done to the orthotics to make them comfortable for myself. The orthotics seemed to help the tailor’s bunions, but not the bunions, which got larger. The orthotics did help my back pain. In my new town, I went to a podiatrist complaining about the pain experienced while wearing the orthotics. He said that the posts on the forefoot were too high and he ripped them off, replacing them with a felt metatarsal pad that he added. He said that orthotics do not help bunions – eventually, whether in two years or ten, I will have to have surgery. He said that it was only the rear post that was necessary, to hold the foot.

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  1. What you have witnessed is not any different than asking 2 chefs the best way to make the same dish. I am not personallyaware of any long term outcome study that shows the efficacy of custom orthotics in slowing or stopping the development of bunions. This may exist, but I do not see it as an easy task to have accomplished. Many variable, such as compliance, people moving, age when the bunion starts etc.Orthotics can be different from one lab to another and certainly from one practitioner to another. I never argue with success. I would respectfully disagree with my colleague who stated orthotics do not help bunions. I certainly have patients who they have. I also have patients who have not benefitted from them as well. Bottom line, if the orthotics are helping you, great and keep wearing them. As far as needing surgery, only the patient can decide if that is reight for them.Good luck.

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