Do All Bunions Require Surgery?

You’re looking at the bump on the side of your big toe; it’s likely you’ve developed a bunion.  Bunions are bony protrusions sticking out from the joint at the base of your big toe. Your big toe has gradually been pushing against your second toe, causing the big toe joint to protrude. If the area is red and sore, there’s significant inflammation. 

Thomas Rambacher, DPM, FACFAS, FAPWCA, a double-board certified podiatrist, sees bunion patients every week and provides the most advanced treatments available to correct this foot deformity.

Why do I have a bunion?

Bunions can develop for a number of reasons. Genetics are a factor; if close family relatives have bunions, you’re more likely to get one. Bunions can also develop from an injury, faulty bone structure, or problematic foot biomechanics. If your foot rolls inward too much when you walk, for example, the extra pressure could start forming a bunion. 

Do I need surgery?

Dr. Rambacher takes X-rays of your foot, performs a physical exam of the foot, and observes your walking gait. If the bunion hasn’t progressed very far and if you’re not experiencing pain or only twinges now and then, you don’t need surgery — at least, not now. 

On the other hand, if you’re in severe pain, your big toe has moved to the side, and the bunion is making it difficult to walk normally, you’re a likely candidate for bunion surgery. 

Conservative bunion treatments

Non-surgical treatments may help you avoid a bunion operation. Here are some of them.

Ice and medication

If your bunion hurts, icing it on and off for 24-48 hours can help relieve inflammation and pain. Over-the-counter pain relievers help; Dr. Rambacher can also prescribe stronger prescription pain relievers for temporary use. 

Footwear change

If you love high heels, you need to transfer your affection. High heels can make a bunion worse. Most high heels have narrow, pointed toes, and your toes are jammed together when you put them on, further training your big toe to move to the side. 

Have the staff at a shoe store measure your foot. Choose flats with a wide toe boat and sandals with good arch support. These can be just as attractive as high heels. 

Bunion splint

You may want to try a bunion splint that you wear at night; use a splint under Dr. Rambacher’s direction. The splint fits over your big toe and helps keep it straight while you’re asleep. 


Dr. Rambacher may prescribe custom orthotics to help correct faulty foot mechanics. Orthotics are prescription shoe insoles designed in a lab that can help correct your walking gait. Perhaps you’re overpronating when you walk and the ball of your foot is rolling inward too much, putting excess pressure on your big toe joint. Or the bones in your feet may have a congenital deformity that has thrown off your gait. 


If your pain is severe and limits your ability to walk, Dr. Rambacher can give you a cortisone injection. The injection helps you feel better for a few months. It gives you breathing time to decide whether an operation is in order if the same amount of pain continues when the shot wears off.

Bunion surgery

Dr. Rambacher, a fellow of the American Board of Podiatric Surgery, uses the most advanced, minimally invasive bunion surgery techniques available today. He corrects the deformity by realigning your toe joint, removing excess bone growth, and ensuring proper position of ligaments and tendons. Upon recovery, your foot will not only look good, but it will feel good, too. 

Call Podiatry Hotline or book an appointment through our online portal if you’re suffering from a bunion and for all of your foot and ankle needs. 

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