Pros and Cons of Big Toe Joint Fusion: The Best Surgery 2020?

Pros and Cons of Big Toe Joint Fusion: This is the most predictable procedure available to the foot and ankle surgery. This is reliable and essential ensures you will only need one surgery if your life if all goes well. The down side is that it is very permanent and you will no longer have motion in the joint.

 

 

Pros and Cons of Big Toe Joint Fusion:

 

The big toe joint fusion is recognized as being the  “most permanent and satisfactory correction of hallux valgus(bunion)”. Numerous studies over the years have indicated that this is the most predictable and effective surgery for any type of bit toe joint deformity or arthritis.

 

big toe joint fusion great toe joint fusion
On these x-rays, the plate and the screws look huge. We have to remember that this is a very thin plate, it is extremely rare for patients to ever feel this plate. I would say that only about 5% of the time in very thin patients do people feel this plate. These are locking screws, so they rarely if ever back out.

 

 

Pros of Big Toe Joint Fusion:

 

  • Better long term results and happiness.
  • More stable.
  • Better pushoff strength.
  • It will not shorten over time like a arthroplasty might(more chronic arthritis will develop).
  • Long term durability.

 

 

bilateral big toe joint fusion for halllux rigidus bunion
This is an example of a bilateral screw based MTPJ fusion patient. This patient had it done many many years ago when plates were not the standard. The downside of this approach is that you have to protect a little bit longer at the beginning. But the end result is just as good!

 

 

Cons of Big Toe Joint Fusion:

 

  • Longer recovery time.
  • No joint motion means less shoe options.
  • Shorter bone may mean less contact to the floor(more pressure on the 2nd metatarsophalangeal joint).
  • No going back unless you get more surgery.

 

big toe joint fusion with a plate 1st MTPJ fusion
This is an example of a six hole plate with one crossing screw. This procedure was performed for hallux rigidus, which is end-stage big toe joint arthritis. This is different than a really bad bunion, this is when you have really bad arthritis.

 

 

 

Frequently asked questions:

 

Primarily used for Hallux Abducto Valgus and Hallux Limitus:

 

  • The big toe fusion is called a McKeever bunionectomy. It is primarily used for both severe hallux abducto valgus deformities(bunions) and stiff big toe joints due to osteoarthritis termed hallux limitus and hallux rigidus.

 

great toe joint fusion recovery time great toe joint
This patient with a metatarsal phalangeal joint fusion had a recovery time of 1 month in a surgical shoe and dressing. Sutures came out at 3 weeks. The patient was then walking for 4 weeks.

 

 

 

Secondarily used for Repair of Failed Surgeries

 

  • The big toe fusion is secondarily used to repair severe/recurrent hallux abducto valgus, failed implant joint arthroplasty (remodelling), hallux varus, primary first MPJ osteoarthritis, post traumatic arthritis, inflammatory and septic arthritis and various other neuromuscular conditions.

 

big toe joint hallux IPJ fusion surgery treatment hallux
This is technically a great toe joint fusion. But this is a fusion of the IPG joint, it is not a fusion of the metatarsal phalangeal joint. There are actually cases of NFL running backs playing while having the screw in their big toe joint! That’s how well you can move after one of these surgeries.

 

 

 

 

People are Usually Very Happy with the Operation

 

  • An appropriately fused big toe joint has shown to have the greatest long term patient happiness from a recurrence standpoint, a pain standpoint and a functionality standpoint.It seems that the only problem is the psychology behind telling a patient that their joint will be fused and they expect that it is much worse than it really is.

 

 

Big toe joint arthritis hallux rigidus
This is an example hallux rigidus or really bad arthritis formation in the big toe joint. Procedure like this needs. The bone removed, as well as the potential fusion of the joint.

 

 

Should I Remodel the Joint or Fuse the Big Toe?

 

  • The big toe joint fusion has the benefit of locking the toe in proper position as well as removing pain in the joint. The big toe joint arthroplasty (remodelling) procedure is beneficial in the case where the position is not a big problem such as in a straight joint with a mild amount of joint damage; the arthroplasty is also beneficial because it allows for more types of shoes to be worn. The benefits of the big toe joint fusion (arthrodesis) is that you will have a greater degree of pushoff strength in the joint and essentially guaranteed prevention of future pain and improper positioning if all goes well with the surgery. The arthroplasty has a quicker healing time but weaker pushoff strength (less of a problem if the patient is already apropulsive).

 

  • Pros: More stable, Better pushoff strength, Better long term results and happiness, will not shorten over time like a arthroplasty might(more chronic arthritis will develop).

 

  • Cons: Longer recovery time, No joint motion means less shoe options, shorter bone may mean less contact to the floor(more pressure on the 2nd metatarsophalangeal joint).

 

Pros and Cons 1st MTPJ metatarsal phalangeal joint fusion of the big toe joint
There are pros and cons to a first MTPJ fusion. The pros are that it is very predictable procedure that will get rid of your pain! This leads to excellent overall results. The downsides are you will never be able to bend your big toe joint again. But in most cases, if you’re considering this procedure, you probably can’t bend your big toe joint anyway.

 

Who should Avoid Big Toe Fusion

 

 

  • People who need to kneel and bend should choose remodeling over fusion. Bowlers and carpet layers need to bend their big toe joint every day, people like this should avoid it.

 

  • People who cannot tolerate being immobilized in a boot for any extended period of time(cast or CAM Walker).

 

  • Anyone who plans to wear heels larger than 1″ tall. This will basically cause you to develop hallux rigidus as the big to will press against the floor in its fused position, causing a callus to form on the inside of the big toe.

 

Big Toe Fusion Operation:

 

  • A detailed guide on the principles of the surgery and how it is performed by the podiatrist.

 

Big Toe Fusion Recovery Time :

 

  • A rough estimate on how long it will take for your joint to fuse and what you can do to speed that up.

 

Big Toe Fusion Complications:

 

-Nonunion and mal-position are the two major complications.

 

-Nonunion- this can be prevented by proper fenestration and ensuring that the patient does not have any systemic problems such as smoking or diabetes. If this does occur the painful non-union will need to be excised and then filled in with a bone graft.

 

 

Bone Spur on Top of the Foot Surgery Recovery Time Protocol:

 

This guide will detail the length of specific step by step bone spur surgery recovery time.

 

Day 1: Top of the Foot Spur Removal Surgery Day:

 

  • The actually surgery takes well under an hour, and your foot is usually numbed up for the rest of the day.
  • Some people don’t need much if any pain medication outside of anti-inflammatories. If you do have pain to this site, then it is normal to have a prescription for a narcotic pain medication for the days immediately after the surgery.
  • After surgery you will wake up with a dressing on your foot. Keep this dressing in place and your pain will be well under control with medication.
  • No implants or bone healing is necessary, except for the healing of bone pain.
  • You can wear a boot over your dressing almost immediately.
  • Most physically able people do not need crutches or a walker unless they have other health issues.
  • Usually there are about 2 sutures in the foot.

 

This is what your dressing will look like immediately after surgery. The best thing to do is to elevate it , keep it protected and get some rest!

 

Day 7:  Top of the Foot Bone Spur Removal Surgery Postoperative Visit #1:

 

  • Within about a week, we have the first postoperative visit.
  • You will have an X-ray at this visit and we will make sure there is no irritation or damage to your dressing.
  • With this dressing change some antibiotic ointment is applied, we make sure you are not having any problems at this time.
  • Sutures are not removed yet at this visit.

 

The incision site will stay covered with the stitches in place following the surgery.

Week 2-3: Top of the Foot Bone Spur Removal Surgery Postoperative Visit #2:

 

  • This can fluctuate depending your overall health needs, physical fitness and life needs.
  • If you are able to rest more, weight less and are really healthy, sutures can usually come out at 2 weeks. Some patients need to walk and be more active, if this is the case you will likely need sutures longer and have a larger dressing.
  • If you swell more and are more tender, they can stay in a little bit longer.
  • If you are a smoker or have decreased healing ability, we may need to keep your sutures in place longer.
  • At this point your incision site should be healed.
  • At this point you will wear a band-aid for 2 weeks and walk in a good supportive running shoe.

 

 

Week 5: Postoperative Visit #3:

 

  • This is what the incision site will look like after the sutures are removed at 2-3 weeks or so.
  • If everything looks good, you no longer need to wear a band-aid.
  • At this point you will still be sore but can transition back into

 

 

2 Months: Postoperative Visit #4:

 

  • At this point you continue wearing a good supportive orthotic and good shoe.
  • If everything is feeling well you should be close to healed.
  • Keep in mind that you will continue improving for about 6 months total. But at this point you should be feeling better than you did prior to when you have a heel spur.
  • Congratulations you

 

 

Treatment algorithm for bunion surgery:

 

  • Find out if a different procedure is best for you.
  • A metatarsal joint fusion may not always be worth it.
  • Many times other procedures are just as effective and the healing time can be much quicker.

 

 

Resources for Big Toe Joint Fusion:

Big Toe Joint Fusion.

 

Big Toe Joint Home Treatment:

  • If you have read the above causes and symptoms, and you are confident that that what you have is big toe joint arthritis, then the below might be a good idea to look through.
  • If you are considering big toe joint fusion, these options may be something to consider before surgery.

 

Instant Pain Relief:

  • The key to instant pain relief is icing. For best results ice 20 minutes at a time.
  • Studies also show that bio freeze or other mental based creams can be very effective.
  • Studies do show that bio freeze can last two times as long as vice. This will give you excellent relief, especially when you’re going to bed in your foot is throbbing.

 

Best Bottom of the Foot & Heel Pain Relief Products
Best & Proven Pain Relieving Gel.
Roll On Version of Biofreeze Gel.
A giant container of value size biofreeze.
Menthol Based Ointment with Hemp Extract
Biofreeze Pain Relief Gel, 4 oz. Tube, Pack of 3 (Packaging May Vary)
Biofreeze Pain Relief Roll-On, 3 oz. Roll-On, Fast Acting, Long Lasting, & Powerful Topical Pain Reliever, Pack of 3 (Packaging May Vary)
Biofreeze Pain Relief Gel, 1 Gallon Pump, Green
HEMPACTIV Hemp Pain Relief Cream  | Hemp + MSM + Arnica + Menthol | Relieve Muscle, Joint & Arthritis Pain | Effective Hemp Pain Cream | 2oz
Price:
$31.74
$24.06
$121.72
$29.99
Overview:
The Proven and Scientifically Published Menthol Based Gel
Same as biofreeze gel, but the roll-on is prefered by some people for their feet, less messy.
8.1 lbs(3.67 kg) of Value Sized Biofreeze!
This is an alternative cream: Basically Biofreeze + hemp extract.
Pros:
Scientifically proven to loosen up and relief pain up to 2x longer than Ice. Less effort than ice and great reviews. 900+ 5 star reviews on Amazon.
The roll-on application of this biofreeze can be easier to apply. Less overall mess.
If you know you already love it and trust the reviews. This is a great value that lasts a long time.
It has great reviews, loved by the all natural crowd. 100s of 5 star reviews with a near perfect rating.
Cons:
Don't put this on open sores or mucous membranes, it will burn! It can run out quick and doesn't prevent pain, just helps it.
Not as easy to spread in other areas, main difference is the roll on applicator, same solution.
A gigantic bottle that could fall over and injure you! Seriously this could be too big in some situations.
Basically looks like menthol(active Biofreeze ingredient), but with hemp extract SKYROCKETING the price.
Important Tips:
Menthol is the active ingredient in this and other hemp based creams. It works similar to ice, but once you apply it you can just move on rather than waiting 20 minutes. **Works great to get your through the night if you have pain sleeping**
Roll-on method is best for the bottom of the feet. No other real advantage. Most patients like it prior to bed for easy sleeping without foot pain.
If you know you love it, this stuff works all over the sore areas in your body not just your foot. I have had many people get me to order this for them in the past and LOVED IT!
The hemp extract is almost nothing and likely a marketing gimmick. It's basically Biofreeze with some hemp extract raising the price.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"Like I stated earlier, I am a huge fan of this product and I will happily buy this product again. I'm so glad I finally found it online (lol), rather than having to make a trip to the pharmacy."
"The main ingredient is menthol and the cool sensation is long lasting. You have to try this product. Trust me, I've tried them all and there's no comparison!"
"This stuff is GREAT! Value sized!!"
"The cream helps with my nerve pain for several hours , giving me relief on the job. It doesn't take much , I use very little , it goes along way, as long as it is rubbed in properly. I will definitely be purchasing this again. I also gave to a friend that has fibromyalgia, she said it helped with her aches and pains to relieve pressure for a few hours. This is definitely a 5 star purchase."
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Bottom of the Foot & Heel Pain Relief Products
Best & Proven Pain Relieving Gel.
Biofreeze Pain Relief Gel, 4 oz. Tube, Pack of 3 (Packaging May Vary)
Price:
$31.74
Overview:
The Proven and Scientifically Published Menthol Based Gel
Pros:
Scientifically proven to loosen up and relief pain up to 2x longer than Ice. Less effort than ice and great reviews. 900+ 5 star reviews on Amazon.
Cons:
Don't put this on open sores or mucous membranes, it will burn! It can run out quick and doesn't prevent pain, just helps it.
Important Tips:
Menthol is the active ingredient in this and other hemp based creams. It works similar to ice, but once you apply it you can just move on rather than waiting 20 minutes. **Works great to get your through the night if you have pain sleeping**
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"Like I stated earlier, I am a huge fan of this product and I will happily buy this product again. I'm so glad I finally found it online (lol), rather than having to make a trip to the pharmacy."
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Bottom of the Foot & Heel Pain Relief Products
Roll On Version of Biofreeze Gel.
Biofreeze Pain Relief Roll-On, 3 oz. Roll-On, Fast Acting, Long Lasting, & Powerful Topical Pain Reliever, Pack of 3 (Packaging May Vary)
Price:
$24.06
Overview:
Same as biofreeze gel, but the roll-on is prefered by some people for their feet, less messy.
Pros:
The roll-on application of this biofreeze can be easier to apply. Less overall mess.
Cons:
Not as easy to spread in other areas, main difference is the roll on applicator, same solution.
Important Tips:
Roll-on method is best for the bottom of the feet. No other real advantage. Most patients like it prior to bed for easy sleeping without foot pain.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"The main ingredient is menthol and the cool sensation is long lasting. You have to try this product. Trust me, I've tried them all and there's no comparison!"
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Bottom of the Foot & Heel Pain Relief Products
A giant container of value size biofreeze.
Biofreeze Pain Relief Gel, 1 Gallon Pump, Green
Price:
$121.72
Overview:
8.1 lbs(3.67 kg) of Value Sized Biofreeze!
Pros:
If you know you already love it and trust the reviews. This is a great value that lasts a long time.
Cons:
A gigantic bottle that could fall over and injure you! Seriously this could be too big in some situations.
Important Tips:
If you know you love it, this stuff works all over the sore areas in your body not just your foot. I have had many people get me to order this for them in the past and LOVED IT!
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"This stuff is GREAT! Value sized!!"
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Bottom of the Foot & Heel Pain Relief Products
Menthol Based Ointment with Hemp Extract
HEMPACTIV Hemp Pain Relief Cream  | Hemp + MSM + Arnica + Menthol | Relieve Muscle, Joint & Arthritis Pain | Effective Hemp Pain Cream | 2oz
Price:
$29.99
Overview:
This is an alternative cream: Basically Biofreeze + hemp extract.
Pros:
It has great reviews, loved by the all natural crowd. 100s of 5 star reviews with a near perfect rating.
Cons:
Basically looks like menthol(active Biofreeze ingredient), but with hemp extract SKYROCKETING the price.
Important Tips:
The hemp extract is almost nothing and likely a marketing gimmick. It's basically Biofreeze with some hemp extract raising the price.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"The cream helps with my nerve pain for several hours , giving me relief on the job. It doesn't take much , I use very little , it goes along way, as long as it is rubbed in properly. I will definitely be purchasing this again. I also gave to a friend that has fibromyalgia, she said it helped with her aches and pains to relieve pressure for a few hours. This is definitely a 5 star purchase."
Affiliate Link (Buying through these links helps support the site): Thank you!

 

Keys to a permanent cure:

  • Accept that you have an injury, even if you’re doing everything right, this inflammation and soreness take 1, 2 or even 3 months to get completely better again.
  • There is no magic solution like a cream that can make it go away permanently and immediately.

 

Get a good supportive running shoe:

  • The first step is to get a good supportive running shoe, if you have any questions with this comes your podiatrist or get something that you would feel comfortable running a marathon in.
  • Take a look at what people are running marathons and, it’s not a decked out signature Nike or Under Armor shoe!
  • The first thing you need to do is look at your shoes: most patients that we see think they are wearing great shoes, but they can actually be terrible shoes.
  • In today’s world of marketing, commercials make it seem like a shoe is great for you, it can actually be a terrible shoe! We see hard-working and well-intentioned athletes come in with terrible unsupported and flimsy shoes. This is even the case if you buy $200 plus shoes!

 

good shoes with orthotics for Achilles tendon pain
These are good shoes with orthotics for ball of the foot and neuroma pain is very effective.

 

The Best  Orthotics:

  • This is very cheap investment to get rid of your foot pain.
  • There are much cheaper over-the-counter custom options available as well.
  • Do your best to avoid the flimsy gel pads.
  • These are our recommended orthotics:

 

Full-length orthotics are the best orthotic for healing your bunion and ball of the foot instability.

The downside is that they do take up much more room in your shoe.

Best Medium to Heavy Duty Heel Pain Orthotics:
Best Overall Orthotic For Everything (Medium Thick Fit)
Best Heavy Duty Orthotic (Thickest Fit)
Best SOFTER Choice For Sensitive Feet (Medium Thick Fit)
Powerstep Pinnacle Plus Met Insoles, Red/Blue
Powerstep Pinnacle Maxx Orthotic Insole, Maroon, Men's 10-10.5 / Women's 12
Plantar Fasciitis Arch Support Insoles for Men and Women Shoe Inserts - Orthotic Inserts - Flat Feet Foot - Running Athletic Gel Shoe Insoles - Orthotic insoles for Arch Pain High Arch - Boot Insoles
Price:
Price not available
$38.95
$19.99
Overview:
These work best in shoes with laces and running shoes. Not good for dress shoes or women's cute shoes.
Biggest and most corrective option. Only use for running shoes or work boots. Not cute shoes.
These are full length inserts, but softer. Great if you can't tolerate the firmer ones. Best for very sore and sensitive feet.
Pros:
Pretty much guaranteed to help you if it fits in your shoes and you give it 2 weeks to get used to. 5,000+ amazon reviews, great track record.
My personal favorite, but not for everyone. Amazing reviews over 3,500. But not for everyone. Only for bigger shoes that can fit them
They are softer and the initial break in time is AMAZING. But longer term benefits are less. >500 Almost 5 star amazon rating.
Cons:
Do not wear these in cute or dress shoes!
Bigger and bulkier than all the other ones. You will be dissappointed if you have a cute women's shoe or dress shoe. This is meant for running shoes and boots.
Great to start with, but don't correct long term as much as the other ones.
Crucial Tips:
Ease in to these, 1-2hrs a day. They are like braces for your teeth, they suck at the beginning! But they will make your feet pain free as 1-2 weeks go by. Don't give up on them after 1 or 2 days. Everyone feels off at the beginning!
This has the most correction, but hardest break in time! IF SENSITIVE, USE A SOFTER PAIR FIRST! But if you get these, you must break them in. Give it 1-2 hours a day, but then you will start to have excellent results. The bad reviews are all people who couldn't fit it into their shoes and gave up too quickly. You have been WARNED!
If you are very sore, TRY THESE FIRST! These are easiest to break in with initially. If you are very sore and rigid, don't use the heavy duty ones to start with.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"These have worked well for my plantar fasciitis. It's not cured, but has helped. I wish they had a higher arch, but they are doing what they are intended to do. Some others have complained about the durability. I've had them for about 5 months, and they are just fine. "
" The Powerstep inserts are definitely the best for me in terms of arch support and comfort, and the Pinnacle Maxx inserts make a MAJOR positive difference in my comfort and ability to get around."
"Plantar Fasciitis pain was getting pretty bad, so I bought these insoles looking for some relief. On Day One, I noticed that it was not as painful to walk as the prior day; still sore but a marked improvement. It's now Day Two and I'm not nearly feeling the pain that I felt before I tried these insoles"
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Medium to Heavy Duty Heel Pain Orthotics:
Best Overall Orthotic For Everything (Medium Thick Fit)
Powerstep Pinnacle Plus Met Insoles, Red/Blue
Price:
Price not available
Overview:
These work best in shoes with laces and running shoes. Not good for dress shoes or women's cute shoes.
Pros:
Pretty much guaranteed to help you if it fits in your shoes and you give it 2 weeks to get used to. 5,000+ amazon reviews, great track record.
Cons:
Do not wear these in cute or dress shoes!
Crucial Tips:
Ease in to these, 1-2hrs a day. They are like braces for your teeth, they suck at the beginning! But they will make your feet pain free as 1-2 weeks go by. Don't give up on them after 1 or 2 days. Everyone feels off at the beginning!
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"These have worked well for my plantar fasciitis. It's not cured, but has helped. I wish they had a higher arch, but they are doing what they are intended to do. Some others have complained about the durability. I've had them for about 5 months, and they are just fine. "
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Medium to Heavy Duty Heel Pain Orthotics:
Best Heavy Duty Orthotic (Thickest Fit)
Powerstep Pinnacle Maxx Orthotic Insole, Maroon, Men's 10-10.5 / Women's 12
Price:
$38.95
Overview:
Biggest and most corrective option. Only use for running shoes or work boots. Not cute shoes.
Pros:
My personal favorite, but not for everyone. Amazing reviews over 3,500. But not for everyone. Only for bigger shoes that can fit them
Cons:
Bigger and bulkier than all the other ones. You will be dissappointed if you have a cute women's shoe or dress shoe. This is meant for running shoes and boots.
Crucial Tips:
This has the most correction, but hardest break in time! IF SENSITIVE, USE A SOFTER PAIR FIRST! But if you get these, you must break them in. Give it 1-2 hours a day, but then you will start to have excellent results. The bad reviews are all people who couldn't fit it into their shoes and gave up too quickly. You have been WARNED!
Amazon Reviewer Comments (Make sure to do your own review research through the link):
" The Powerstep inserts are definitely the best for me in terms of arch support and comfort, and the Pinnacle Maxx inserts make a MAJOR positive difference in my comfort and ability to get around."
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Medium to Heavy Duty Heel Pain Orthotics:
Best SOFTER Choice For Sensitive Feet (Medium Thick Fit)
Plantar Fasciitis Arch Support Insoles for Men and Women Shoe Inserts - Orthotic Inserts - Flat Feet Foot - Running Athletic Gel Shoe Insoles - Orthotic insoles for Arch Pain High Arch - Boot Insoles
Price:
$19.99
Overview:
These are full length inserts, but softer. Great if you can't tolerate the firmer ones. Best for very sore and sensitive feet.
Pros:
They are softer and the initial break in time is AMAZING. But longer term benefits are less. >500 Almost 5 star amazon rating.
Cons:
Great to start with, but don't correct long term as much as the other ones.
Crucial Tips:
If you are very sore, TRY THESE FIRST! These are easiest to break in with initially. If you are very sore and rigid, don't use the heavy duty ones to start with.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"Plantar Fasciitis pain was getting pretty bad, so I bought these insoles looking for some relief. On Day One, I noticed that it was not as painful to walk as the prior day; still sore but a marked improvement. It's now Day Two and I'm not nearly feeling the pain that I felt before I tried these insoles"
Affiliate Link (Buying through these links helps support the site): Thank you!

 

 

If you have a dry shoe, consider a recommended dress shoe orthotics:

 

Best Dress Shoe Orthotics:
Best Fitting Dress Shoe Orthotic (3/4")
Best Full Length Dress Orthotic.
Powerstep Signature Dress 3/4-Length Insoles – Dress Shoe Insoles for Men and Women
Powerstep Signature Dress Full-Length Insoles for Men and Women
Price:
Price not available
Price not available
Overview:
This is my top choice due to best fit. It is a little less supportive than full length, but fit is the key in dress shoes!
Best option if you can fit a full length orthotic. This does give you most control.
Pros:
Excellent overall fit. This will fit in almost every dress shoe. Excellent reviews and reasonable cost overall. Can't go wrong in most cases.
Great color dress option. Not the most corrective, but very color and dress appropriate. Great Reviews. Better correction and relief than the 3/4" length.
Cons:
Less correction than full length and heavy duty orthotics.
These can have a poor fit in in some shoes. If you have tight shoes, DO NOT BUY the full length orthotic! You have been warned.
Crucial Tips:
If you haven't used dress orthotics before, get this one and avoid poor fit. If you wear dress shoes every day with room, the full length might give you more support.
This is will work great in most men's shoes that are not pointy. If you have a rounded toe box, this will probably work well. If a tight shoe go with the 3/4" length.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"Great orthotics. Ease in to shape to your foot just enough, yet comfortable right out of the box. Leather construction makes them breathable. They are good for a wide foot, while not over stretching and ruining one's shoes!"
"I have bought many different OTC orthotics due to plantar fasciitis. These are among the best. I use them exclusively now and they feel good inside both sports and shoes I wear to the office that have removable insoles."
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Dress Shoe Orthotics:
Best Fitting Dress Shoe Orthotic (3/4")
Powerstep Signature Dress 3/4-Length Insoles – Dress Shoe Insoles for Men and Women
Price:
Price not available
Overview:
This is my top choice due to best fit. It is a little less supportive than full length, but fit is the key in dress shoes!
Pros:
Excellent overall fit. This will fit in almost every dress shoe. Excellent reviews and reasonable cost overall. Can't go wrong in most cases.
Cons:
Less correction than full length and heavy duty orthotics.
Crucial Tips:
If you haven't used dress orthotics before, get this one and avoid poor fit. If you wear dress shoes every day with room, the full length might give you more support.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"Great orthotics. Ease in to shape to your foot just enough, yet comfortable right out of the box. Leather construction makes them breathable. They are good for a wide foot, while not over stretching and ruining one's shoes!"
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Dress Shoe Orthotics:
Best Full Length Dress Orthotic.
Powerstep Signature Dress Full-Length Insoles for Men and Women
Price:
Price not available
Overview:
Best option if you can fit a full length orthotic. This does give you most control.
Pros:
Great color dress option. Not the most corrective, but very color and dress appropriate. Great Reviews. Better correction and relief than the 3/4" length.
Cons:
These can have a poor fit in in some shoes. If you have tight shoes, DO NOT BUY the full length orthotic! You have been warned.
Crucial Tips:
This is will work great in most men's shoes that are not pointy. If you have a rounded toe box, this will probably work well. If a tight shoe go with the 3/4" length.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"I have bought many different OTC orthotics due to plantar fasciitis. These are among the best. I use them exclusively now and they feel good inside both sports and shoes I wear to the office that have removable insoles."
Affiliate Link (Buying through these links helps support the site): Thank you!

 

 

If you have acute shoe or a woman’s shoe, consider these minimalist orthotics.

 

Best Flat Shoe (Non-Lace Up) Orthotics:
Best Overall 3/4" length option. (Not Heavy Duty, But Fit Focused)
Best Choice For Tight Women's Shoes or High Heels..
Thin Arch Support Shoe Orthotic Inserts for Women and Men by Powerstep, SlimTech 3/4 Length, Original Cushioning Shoe Insoles, Relieves Plantar Facsiitis, All Arch Types, Foot, Heel and Knee Pain
Powerstep SlenderFit Women's Fashion Orthotic High Heel Insole
Price:
Price not available
Price not available
Overview:
Great 3/4" choice. These work great in every shoe without laces. Not meant for heavy duty correction.
These are the best fitting for the most narrow shoes. Some but not great correction.
Pros:
Excellent fit, they are reliable with excellent reviews. You are going to be happy with these, just never SUPER happy because they don't correct as much.
They will fit in even the tightest shoes! Guaranteed to make you feel better, but you know what you are getting in a tight shoes. Great reviews and price.
Cons:
They are not super corrective. In some cases its like trying to using a 2 seat car to haul gravel. It looks and feels great but does
At the end of the day high heels and slender orthotics help, but never cure all your pain. Make the best of a painful shoe!
Crucial Tips:
These have a faster break in period than the heavy duty type. If after a few weeks
**WARNING***: If your shoe almost just barely fits onto your foot, this WILL NOT FIT! Be aware, it still needs a small amount of space to fit.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"This orthotic is the best I have tried, the other Powerstep have too high an arch for my feet, and are too thick in one's shoes, this one is just perfect, mild pronation and arch support, they are very comfortable yet do not give way due to their rigid support underneath, I use them in all my shoes as they are 3/4 and I do not have to take the sole from my shoes nor order a size up as I used to."
"These insoles provide as much support as the Powerstep originals. The insoles are comfy and they are long lasting. I've had one pair for a year now and they are just starting to show signs of wear. "
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Flat Shoe (Non-Lace Up) Orthotics:
Best Overall 3/4" length option. (Not Heavy Duty, But Fit Focused)
Thin Arch Support Shoe Orthotic Inserts for Women and Men by Powerstep, SlimTech 3/4 Length, Original Cushioning Shoe Insoles, Relieves Plantar Facsiitis, All Arch Types, Foot, Heel and Knee Pain
Price:
Price not available
Overview:
Great 3/4" choice. These work great in every shoe without laces. Not meant for heavy duty correction.
Pros:
Excellent fit, they are reliable with excellent reviews. You are going to be happy with these, just never SUPER happy because they don't correct as much.
Cons:
They are not super corrective. In some cases its like trying to using a 2 seat car to haul gravel. It looks and feels great but does
Crucial Tips:
These have a faster break in period than the heavy duty type. If after a few weeks
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"This orthotic is the best I have tried, the other Powerstep have too high an arch for my feet, and are too thick in one's shoes, this one is just perfect, mild pronation and arch support, they are very comfortable yet do not give way due to their rigid support underneath, I use them in all my shoes as they are 3/4 and I do not have to take the sole from my shoes nor order a size up as I used to."
Affiliate Link (Buying through these links helps support the site): Thank you!
Best Flat Shoe (Non-Lace Up) Orthotics:
Best Choice For Tight Women's Shoes or High Heels..
Powerstep SlenderFit Women's Fashion Orthotic High Heel Insole
Price:
Price not available
Overview:
These are the best fitting for the most narrow shoes. Some but not great correction.
Pros:
They will fit in even the tightest shoes! Guaranteed to make you feel better, but you know what you are getting in a tight shoes. Great reviews and price.
Cons:
At the end of the day high heels and slender orthotics help, but never cure all your pain. Make the best of a painful shoe!
Crucial Tips:
**WARNING***: If your shoe almost just barely fits onto your foot, this WILL NOT FIT! Be aware, it still needs a small amount of space to fit.
Amazon Reviewer Comments (Make sure to do your own review research through the link):
"These insoles provide as much support as the Powerstep originals. The insoles are comfy and they are long lasting. I've had one pair for a year now and they are just starting to show signs of wear. "
Affiliate Link (Buying through these links helps support the site): Thank you!

 

 

Injections:

  • This is not something that we would recommend doing at home, but a doctor can help you with this.
  • If you do have severe pain that is really preventing you from doing anything, this may be an option in the right circumstances.

 

Medications:

  • Anti-inflammatory medications could be good, but we do not recommend this as a long-term solution.
  • Focus on the orthotics in the shoes.

 

 

When is surgery a good option? Probably only 10% of the time!

  • If you have tried all the above stuff, and a couple months have gone by and you have not started to improve at all, then further and imaging like an ultrasound, x-ray or MRI might make sense.
  • If you have long-term permanent damage to the big toe, especially if it has been going on for over 6 to 12 months, then you may need surgery.
  • Bunion surgery has its benefits, but any type of surgery may have its negatives.
  • Make sure to check with a podiatrist to see if you qualify. You may be one of the 10% for whom it may be a great idea!