Non-surgical treatment cannot usually reverse an established bunion, but it can reduce pressure and improve comfort. Wide toe-box footwear, avoidance of irritating shoe shapes, padding, toe spacers, activity modification and orthoses where biomechanically appropriate may all be useful.
The amount of conservative treatment required before surgery depends on the severity of symptoms and whether practical measures have been genuinely tried. A patient who remains comfortable in suitable footwear may not need surgery. A patient who has persistent pain despite appropriate shoe modification and other measures may reasonably move to a surgical discussion.
There is little value in repeating unsuccessful conservative treatments indefinitely simply to delay a decision. Equally, surgery should not be the first response when simple changes have not yet been attempted.
The purpose of non-surgical care is both therapeutic and diagnostic. It helps establish how much of the problem is caused by pressure, footwear, joint irritation or mechanical overload, and whether symptom control is possible without correction of the deformity.