Surgery is considered to be a last option when more conservative fails to alleviate symptoms (such as the above techniques outlined in the section above.) Such as bunionectomies may be used to surgically remove bunions and other foot and ankle Deformalities, arthrodesis (or fusion of joint spaces) for inflammatory processes, and Surgical reconstruction (i.e. invasive measures of manipulating neuromusculoskeletal structures) to treat other deformalities. One should note that orthotics, physical therapy, NSAIDs, DMARDs and a change of shoe will act in compliments to surgical intervention, and in most cases will be required for optimal recovery.