Can Bunions Get Better Without Surgery?

Key points in 30 seconds

1. It's hard to reverse the angle of the bend itself without surgery.
2. However, the pain and how fast it bends further can be managed without surgery.
3. Shoes with a narrow toe box are themselves a force pushing the big toe.
4. When the arch has collapsed, more of your weight shifts toward the big toe.
5. If your toes overlap or walking is hard, a surgical consultation comes first.

What we often hear

• "My big toe is bent, so shoes don't fit."
• "I was told surgery is the only option."
• "It seems to be bending more and more."

Can bunions get better without surgery?

It's hard to reverse the angle of a toe that has already bent without surgery. However, the pain and how fast it bends further can be managed without surgery.

There's a reason we make this distinction first. If you take "it can be corrected without surgery" at face value, you'll expect the shape to go back to normal. That doesn't happen.

What exactly is a bunion?

It's a condition where the big toe bends toward the second toe and the big toe joint sticks out toward the inside. The bump rubs against the shoe, causing pain and swelling.

The bump isn't bone that has grown. As the toe is pushed outward, the joint at its base sticks out toward the inside. That's why reducing the force pushing the toe is the core of managing it.

What can be done without surgery?

We get rid of pressure points in your shoes, support the foot so weight doesn't pile onto the big toe, and build up the toe and sole muscles. These three are the core.

Shoes matter a lot. Shoes with a narrow toe box are themselves a force constantly pushing the big toe. No matter how well you manage it, if you wear those shoes every day, the pushing force wins.

When the arch has collapsed, more of your weight shifts toward the big toe as you walk. So when we look at a bunion, we look at the arch of the whole foot too.

When should I consider surgery?

If the angle is large, the pain continues despite management, and it starts to get in the way of walking, a surgical consultation is needed. In those cases, we bring that up first.

If thick calluses form under the second toe or the toes start to overlap, the load distribution across the whole foot has already broken down. At that point we recommend consulting an orthopedic surgeon.

What are the limits of this judgment?

We don't have numbers on how much management can slow the progression. What's written here is what we've seen in the clinic.

One more thing. Bunions are closely tied to the foot shape you're born with. They can't be explained by shoes alone, and it's common for others in the family to have the same feet. The accurate thing is to tell you separately what management can and can't do.

We don't tell you we can reverse the angle of the bend. But the pain and how fast it bends further can be managed.

If your big toe hurts and choosing shoes has become hard, come see us. We'll start by telling you what can be done now.

Results of management differ from person to person, depending on inborn foot shape and how far the toe has bent.