Bunions tend to progress slowly, because the joint alignment does not correct itself. The speed varies a lot: some people see little change over a decade, others progress faster. Your podiatrist can measure the joint angle and, where useful, request an X-ray so there is a baseline to compare against at review. Managing load and footwear early gives the joint the best chance of staying comfortable.

No. In adults, spacers and night splints do not change the bony alignment of the joint, because the position is set by the bones and the joint capsule. They can still be worth using for comfort, by separating rubbing toes or easing tension at night. Your podiatrist will tell you whether a spacer is likely to help your symptoms or simply take up room in the shoe.

A bunionette, sometimes called a tailor’s bunion, is the same type of change on the other side of your foot. The joint at the base of the fifth toe becomes prominent, and the little toe angles inwards. It rubs against the outside of the shoe and often builds callus. Treatment follows similar principles: footwear width, offloading the pressure point, and reducing hard skin.

Yes. When the big toe stops taking its share of load, pressure shifts to the second and third toes. That can cause callus under the ball of the foot, pain in the smaller toe joints, or toes that start to claw. Some people also change how they walk to avoid pushing off, which can load the outside of the foot, the ankle or the knee.

Most people do not. Surgery is generally considered when pain persists despite footwear changes, offloading and orthotic therapy, or when the toe position stops you doing daily activities. It is a decision made with a surgeon, and recovery involves a period of restricted weight-bearing. Our podiatrists do not perform bunion surgery, though we can assess you and arrange a referral [CONFIRM: referral pathway].

Footwear alone does not create a bunion. The underlying structure of your foot and your family history set the risk, and narrow or high-heeled shoes then accelerate the change by pushing the toes together and loading the forefoot. That is why bunions also occur in people who rarely wear heels. It also means changing your shoes can slow progression, even though it will not reverse the bump.