The presence of bunions in the feet can also be referrer to as hallux abducto valgus deformity, which literally means lateral deviation of the big toe. This can be caused by genetics but is also associated with a history of tight fitting shoes. A bunion can be treated conservatively with changing shoe gear, therapy, and orthotics. Usually, these treatments help with symptoms, but they do not correct the structural problem. In patients with "extremely severe" bunion deformities, surgery is usually necessary and can be curative. In the presence of severe bunions with significant pain, this suggests actual damage to the bones, tendons, ligaments, and bursa. This is the primary reason that bunion deformities can, in fact, lead to problems later in life. It is not unusual for someone to put off surgery, unaware that they could have degenerative destruction of the structures in the foot. If you have extremely severe symptoms now, there is likely already damage and arthritis in the surrounding structures, which causes difficulty putting weight on the foot, walking, and, of greater concern is the likelihood for bio mechanical changes in the foot (abnormal appearance of the foot related to a shift in weight bearing on certain parts of the foot to prevent pain). It you have severe symptoms, any number of problems could e present relate to the bunion. If you haven't had an MRI it would be advisable for you to do so immediately to evaluate surrounding structures for pathology and/or surgically correctable problems. Without surgery in severe cases, there would be eventual worsening with development of arthritis and cartilage, tendon, and ligament damage, which would lead to problems walking. Your feet are supporting your body weight and this pressure can cause substantial pain with full weightbearing. Options exist including the use of a cane, walker, crutches, ankle brace or orthotic. In summary, there is a high risk for problems with walking and weight bearing later in life in someone who has extremely severe bunions at a younger age. I recommend starting treatment and considering surgery to minimize the risk for these problems!