Pain is usually the main reason a patient seeks bunion treatment, but the impact of a bunion can be broader. Some people experience difficulty fitting shoes even when pain is intermittent. Others develop recurrent redness, bursitis, callus formation or pressure beneath the lesser metatarsal heads.
As the big toe drifts towards the second toe, it may contribute to crowding, crossover deformity or hammer toe changes. These associated problems can make footwear more difficult and may alter the way weight passes through the forefoot.
Even so, surgery should not normally be recommended for appearance alone. A patient who is comfortable and functioning well is unlikely to gain enough from surgery to justify the recovery and risks. The discussion is strongest when the deformity is producing a meaningful clinical problem.
Each person’s circumstances are different. Occupation, activity level, footwear requirements, other medical conditions and capacity to complete postoperative rehabilitation all influence whether surgery is appropriate.