The best initial management of a saddle bone deformity is simply to avoid closed in footwear as much as possible as that will mean that there is no pressure on it. Sometimes you can just simply remove the laces from the eyelets in the shoe over the area of the enlarged bone and that could be enough to get pressure off it for the symptoms to improve. Another way to get pressure off the area is to stick a pad under the tongue to the shoe over the area. These pads can be shaped like a donut with a hole in the middle or a U shape. Both of these are designed to get pressure off the painful area. Adhesive felt can be used and stuck under the tongue of the shoe. If this works well, then a more permanent material such as poron can be used and glued in place for the long term. If the saddle bone deformity is particularly swollen then a steroid injections and nonsteroidal anti-inflammatory drugs may be needed in the short term to get relief. If these measures do not work for a saddle bone deformity, there are surgical options to excise the bone and fuse the joint.