If possible, the shoe should be made to fit the foot, not the foot to fit the shoe. Only when reasonable footwear modifications have been tried and failed should surgery be considered. Indeed, many patients do not wish to have an operation, but only help to find shoewear or advice on the natural history of the condition: should I have an operation now before it gets worse? (Answer - no, except possibly in a few high-risk bunions).
If the patient is comfortable in low-heeled lace-up shoes with a wide front, they should wear such shoes and do not need to be exposed to the risks of surgery. We do not view the inability to wear high-heeled fashion shoes as an indication for an operation.
Our podiatrist and orthotist will advise on choice of shoes, and the orthotist keeps catalogues of shoes and helpful shops which can be sent out by post or discussed directly.
Patients often ask about the use of orthotics or bunion splints. There is no evidence that these can improve an established hallux valgus; the evidence that splints can prevent a bunion progressing is inconclusive