Recent systematic reviews find that non-surgical devices may improve pain and, in some studies, modestly affect alignment, but results are variable and study quality is limited. Orthoses are most rational when there is a defined load-related symptom or associated mechanical problem.
After surgery, an orthosis is not automatically required. It may be considered for persistent transfer pressure, associated hindfoot mechanics, unequal loading or another diagnosis. A device that makes the shoe tighter can worsen medial or dorsal pressure.
Use bunion pads to reduce shoe friction, not to force alignment.
Stop toe spacers that cause numbness, rubbing or lesser-toe crowding.
Review orthoses when shoes, activity or symptoms change.
Do not assume a previous prescription remains appropriate after surgery alters foot shape.
Should everyone wear orthoses after bunion surgery?
No. They are prescribed for a specific clinical reason, not as a universal requirement. Comfortable function without an orthosis is a satisfactory outcome.