Do Bunions Always Require Surgery?

Mar 15, 2024
If you're struggling with bunions and unsure about what your next step should be, this is for you. Learn more about possible treatments options, including surgical correction — and when bunion surgery may be necessary.

Bunions are bony bumps that typically form at the base of the big toe. Aside from being a cosmetic concern, they’re also likely to throw off the alignment of your foot. Bunions can also cause pain and discomfort, and limit the type of shoes you can wear comfortably.

There are various ways to treat mild bunions, ranging from medication and physical therapy to custom orthotics. Severe bunions, on the other hand, often require corrective surgery

At South Texas Foot Surgeons, PA, in San Antonio, and Kerrville, Texas, our team of podiatrists can determine if you need surgery for your bunions, or if a more conservative approach can help you attain effective relief for the time being.

Here, we help you understand how bunions develop, why it’s necessary to treat them, and when surgery may be the best solution. 

What causes bunions to form?

A bunion forms when your big toe pushes inward against the adjacent toe instead of pointing straight ahead. When this happens, the joint at the base of your big toe progressively angles outward, and eventually forms into a bumpy, bony protrusion. 

There are a few reasons why bunions form. For some people, bunions run in the family because of how their feet are genetically shaped. For others, wearing narrow shoes that squeeze the toes together can push the big toe out of alignment. A chronic condition that undermines the joint structures of your foot, like arthritis, can also lead to bunions.

Why should you treat bunions?

Bunions often start out as a slight inconvenience, but without proper care, they can quickly cause significant pain. Your shoes can rub against the bony protrusion and irritate your skin, and the pressure on the joint can lead to chronic pain.

In some cases, the bunion can also set the stage for arthritis in the big toe joint, making movement even more difficult. Fortunately, early treatment can help slow bunion progression and keep your symptoms from getting worse.

Treatment options

Surgery isn't always the first line of defense against bunions. In many cases, non-surgical treatments can effectively manage your symptoms and stop the bunion from worsening. Effective options include:

  • Proper footwear: Shoes that provide plenty of space for your toes can relieve pressure on the bunion and ease pain
  • Orthotic devices: Custom orthotics redistribute pressure across your foot, helping to counteract the underlying issues that cause bunion formation and progression
  • Physical therapy: Exercises that strengthen your foot and improve flexibility help manage symptoms and prevent the bunion from worsening
  • Medications: Over-the-counter pain relievers and anti-inflammatory medications can temporarily ease your discomfort 

Treating bunions helps alleviate pain, avoid complications, and keep your feet healthy and functional.

When does bunion surgery become necessary?

While many bunions can be managed with simpler treatments, there are times when surgery is the right option. For example, if first-line bunion treatments — like wider shoes, custom inserts, or medication — haven’t helped your bunion, surgery might be the next best step. 

Why? Persistent pain that interferes with your daily life is a clear sign that conservative bunion care measures aren't enough. Sometimes, despite all efforts, a bunion may continue to grow and cause more problems. 

Surgery can correct the toe's alignment and stop the bunion from getting bigger. During surgery, your bones, ligaments, tendons, and nerves are realigned so the big toe can return to its correct position. Our foot specialists can help you understand the different surgical options and what to expect regarding recovery.

Minimally invasive bunion surgery specialists

Bunions don't always require surgery; understanding your options can help you make the best decision. With the right combination of treatments, many people are able to relieve pain and discomfort, improving their quality of life. 

Our team can help you make an informed decision about your care. And if surgical correction happens to be the best course of action for your bunion, we can help — we specialize in minimally invasive bunion surgery, including Lapiplasty® 3D bunion correction and LapiFuse™.


If you're struggling with bunions and looking for an effective treatment plan, give us a call today or click online to schedule a visit at your nearest South Texas Foot Surgeons, PA, office in San Antonio or Kerrville, Texas, anytime.