A brief review of how bunions develop is helpful in understanding why some products on the market work better than others in treating bunions and bunion pain.
In general, most bunion deformities are a result of foot structure and function which are genetic. As the heel strikes the ground when walking, the joints of the foot unlock and absorb impact. Referred to as pronation, the arch collapses causing the feet to flatten 1. This flattening causes excessive tension on the tendon in the upper mid-foot that enables the big toe to bend upward (extensor hallucis tendon). The tendon contracts which then forces the big toe to be pulled laterally toward the second toe. This is what causes the initial deviation.

Over time there is a backward force placed on the first metatarsal bone by the big toe, and the first metatarsal begins to move away from the second metatarsal bone. Due to these changes, there is now more pressure on the side of the first metatarsal bone from shoe pressure which causes a thickening of bone and eventually in the formation of a bunion deformity (2).

Prior to selecting a treatment for bunions, it is prudent to address the underlying cause of the deformity which is not just in the forefoot where the bump is located; rather, the treatment needs to address foot function.

Foot function includes the up and down motion of the two arches in the foot: the longitudinal arch, which is the obvious one that many refer to as the foot arch, and the anterior transverse arch, which runs transversely across the mid-foot 3.In some cases, wearing a proper-fitting orthotic will address the underlying foot function, helping to deter further progression of a bunion deformity.