Custom orthotics are used in the treatment of bunions, whether in efforts to stave off surgery or to assist in reducing recurrence of a bunion after surgery. These inserts go in the shoes and many people ask if they make the shoes tighter or if they will need a larger shoe to accommodate them. I find that a lot of people are wearing a shoe size that is 1/2 to 1 full size to small in the first place. Therefore, these patients will find it best to wear the appropriate fitting shoe with their custom orthotics. Aside from this, the custom orthotic can be built more slim for certain shoes and can be modified to take up as little space as possible in the toebox. So it will depend on what orthotic and shoe are used whether you feel pressure on your bunion and our goal is to make sure these are comfortable for you!