Do All Bunions Require Surgery?

You’ve developed a bony mass on the side of your big toe. It’s especially painful whenever you’re working out at the gym or even while walking. You know exercising is good for your health and you don’t want to become a couch potato. It’s time for a visit to the doctor. 

Dr. Peter Bregman at the Bregman Foot-Ankle & Nerve Center treats bunion patients every week. He’s helped hundreds of patients suffering from this foot condition. Dr. Bregman takes X-rays, examines your feet, and studies your walking gait. The X-rays show how far the bunion has progressed and helps determine treatment. 

Why do I have a bunion?

You may wonder how you developed a bunion. Your foot structure, foot injuries, walking gait, and family history can all play a role. Suffering a foot injury or having flat feet with low arches can cause a bunion. The way you walk may also contribute to your bunion; you may put extra pressure on your big toe, causing it to turn inward. Your genes play a significant role; if others in your family have had bunions, you’re more likely to develop one. 

Do all bunions require surgery?

If your bunion isn’t causing pain, you’re not an immediate candidate for surgery. If your pain is on the mild side, conservative treatment may work. But if the bunion is painful on a regular basis or is causing your second toe to move out of its normal position, the answer is yes, you need surgery. 

Conservative treatments for bunions

Following are several conservative treatments that help reduce bunion symptoms.

Pain relievers 

You may already be using over-the-counter pain relievers, which can reduce some of the inflammation from your bunion. Pain medication won’t solve the problem, and long-term use isn’t recommended because it can result in organ damage. 

Change of footwear 

Dr. Bregman checks with you on what type of shoes you’ve been wearing. If you normally wear high heels, he recommends you switch to flats with a wide toe box. Those pointed-toe shoes cram your toes together into an unnatural position and have likely contributed to the growth of your bunion. 

When you start wearing flats, you’ll likely notice that your foot can breathe, and you may feel less discomfort. Changing your footwear may slow the progression of your bunion. 


Dr. Bregman examines your walking gait. If your foot rolls inward when you’re walking, you’re overpronating. Excess pronation increases the pressure on the inside section of the ball of your foot, including your big toe. Walking this way can result in a bunion as well as other foot issues. 

Dr. Bregman may recommend orthotics, which are prescription shoe inserts that help correct your overpronation. They may contain special arch support and heel support to prevent your foot from rolling inward. A lab creates custom orthotics designed specifically for your feet.


A steroid injection helps relieve inflammation if your pain is severe. You’ll have relief for a few months, but it’s not a permanent solution. 

Bunion surgery

If these treatments don’t help relieve your pain, Dr. Bregman recommends surgery. He has performed well over 1,000 bunion surgeries and has always kept ahead of the curve on the latest and most effective procedures. 

Right now, Dr. Bregman utilizes three different types of procedures based on the patient’s needs and the deformity present. These include the Scarf procedure, Lapiplasty, and Minimal Incision Bunion Surgery; the latter procedure has a small half-inch incision and works well for most patients. Having a consultation with X-rays allows Dr. Bregman and you to make the right decision about which procedure is appropriate for you.

Call Bregman Foot-Ankle & Nerve Center or request an appointment through the online portal today. 

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