A bunionette is a bump on the outside of the fifth toe joint. Bunionettes are not as common as bunions, which affect the great toe joint, but are very similar in cause, symptoms, and treatment. Bunions and bunionettes can both be present at the same time.

Bunionettes are often referred to as tailor’s bunions as tailors would sit cross legged all day long, pressing the outside edge of their feet down into the ground. This constant pressure and rubbing would lead to pain and irritation to the outside edge of the prominent fifth toe joint.

The bump is only a visible sign of the underlying problem however. The bump is generally caused by a malalignment of the fifth metatarsal, the bone just before the fifth or little toe joint. It is rare for the bump to be caused by a growth or bone spur. This malalignment of the metatarsal results in malalignment of the joint and hammer toe deformity of the fifth toe itself.

Bunionettes are generally the result of genetic instability and faulty foot alignment. Bunionettes are a progressive disorder. They will get bigger over time. Unfortunately, we are not able to predict how large or how bad they will be in the future. If they are causing pain, difficulty, or other problems they should be addressed.

Treatment:
While shoes DO NOT cause bunionettes, they do make them more symptomatic. At a minimum, wide shoes, or shoes with an anatomic foot shape, where they are wider and boxier in the forefoot are recommended. Shoe inserts and custom orthotics can help with pain on the bottom of the foot. Toe pads, toe splints, and toe socks can sometimes help with pain and are generally worth a try. Stay away from splints with rigid components as these are generally painful to use and cannot be worn with shoes.  Foot exercises may be helpful if one is diligent in doing them. Rest, ice, and pain medication such as NSAIDs or acetaminophen can also be helpful in managing pain. Steroid injections can be helpful when pain is significant. Surgical correction can be helpful if conservative care does not provide adequate relief.

If you are having significant pain and discomfort, the bunionette is limiting physical activity, or affecting your quality of life, schedule an appointment now for an evaluation and discussion of your feet and treatment options.