Foot orthoses are frequently recommended for bunions, but their role should be explained carefully. An orthosis sits beneath the foot; it does not directly move the first metatarsal back into a permanently corrected position. Its potential benefit comes from modifying load, improving comfort and treating associated mechanical problems.
Orthoses may be considered when bunion symptoms occur alongside a flat or unstable foot, pain beneath the lesser metatarsal heads, callus formation, transfer loading or fatigue during walking. They may also improve shoe comfort when designed with appropriate forefoot accommodation. The prescription should respond to the patient’s symptoms and examination rather than the presence of a bunion alone.
Evidence suggests some non-surgical interventions, including orthoses, may reduce pain in the short to medium term. However, study quality and treatment designs vary. Any claim that orthoses can reliably straighten an adult bunion or permanently halt progression would be too strong. Their success is better judged by pain reduction, improved activity tolerance and reduced secondary pressure.
Fit is critical. An orthosis that crowds the foot inside a narrow shoe may worsen symptoms. Footwear must have sufficient width and depth, and the device should not increase pressure over the bunion. Sometimes a simpler insole or local accommodation is more appropriate than a highly controlling device.
Orthoses are therefore neither essential for every bunion nor useless because they cannot correct the bone. They are one option for selected patients whose symptoms or associated mechanics are likely to respond.