All bunions do not require treatment. For those with bunions desiring treatment, there are both nonsurgical and surgical treatment options available while non-surgical treatments cannot reverse the bunion. They can be useful in symptom management. Non-surgical treatment of bunion deformities includes shoe modifications, which would be the choice of shoes with a wide toe box and avoiding narrow or pointed shoes, padding placed over the bunion or spacers between the big toe and the second toe, modifying activity and avoiding long periods of standing or walking, use of over the counter or prescription anti-inflammatory medications to reduce pain and inflammation, icing, which can also reduce pain and inflammation, inserts, or orthotics, which can be useful in reducing the pressure placed on the bunion deformity. And while not frequently used, occasionally injection therapy can be considered. If a bursa is present in association with the bunion deformity, sometimes surgery is an appropriate consideration, when despite attempts at non-surgical treatment, there is continued pain, difficulty wearing shoes and difficulty with desired activities.