The term “bunion” generally describes any bony lump near a toe joint, leading to the common question of whether one can form on the outside of the foot. While the classic bunion is located on the inside, near the big toe, a similar condition occurs on the opposite side of the foot. This lump on the outer edge is a distinct deformity with its own medical name and anatomical location. The appearance and symptoms of this outer bump are so similar to the traditional bunion that the confusion is understandable.
What a Traditional Bunion Is
The common bunion, medically known as Hallux Valgus, is a deformity affecting the joint at the base of the big toe, the first metatarsophalangeal (MTP) joint. This condition involves a complex misalignment where the first metatarsal bone drifts away from the foot’s midline, and the big toe deviates inward toward the smaller toes. The deviation of the big toe can be measured, with an angle greater than 15 degrees considered abnormal. Over time, the joint capsule can become inflamed, leading to redness and swelling, often aggravated by pressure from tight footwear. This misalignment can also lead to secondary problems, such as hammertoes in the adjacent toes and calluses due to altered weight distribution.
The Deformity on the Outside of the Foot
The lump that forms on the outside of the foot, near the little toe, is called a Tailor’s Bunion or a Bunionette. This condition involves the fifth metatarsal bone protruding outward while the little toe moves inward, making it anatomically similar to Hallux Valgus. The name “Tailor’s Bunion” is a historical reference to tailors who often sat cross-legged, pressing the outside edge of their feet against the ground. The symptoms of a Bunionette mirror those of a Hallux Valgus, including a noticeable bony lump, localized pain, and inflammation. The bump frequently rubs against shoes, leading to skin irritation or the formation of an acutely inflamed fluid-filled sac called a bursa.
Common Causes of Foot Deformities
The underlying causes for both bunions and Bunionettes are primarily rooted in the biomechanical structure of the foot. An inherited faulty mechanical structure, such as a specific foot shape or abnormal bone length, often predisposes an individual to these deformities. External factors, particularly footwear, can significantly accelerate and aggravate the condition. Wearing shoes that are too tight, too narrow, or pointed in the toe box crowds the toes and places undue pressure on the joints. High-heeled shoes also contribute by forcing the foot forward and shifting body weight onto the forefoot, causing bones to move out of alignment over time.
Non-Surgical and Surgical Treatment
Treatment for both Hallux Valgus and Bunionettes typically begins with conservative, non-surgical approaches aimed at managing pain and preventing progression. The initial step involves modifying footwear to shoes with a wide, roomy toe box that accommodates the bony prominence without friction. Non-medicated bunion pads, anti-inflammatory medications (NSAIDs), or icing the inflamed area can help reduce irritation, swelling, and control pain. Custom or over-the-counter orthotic inserts are often recommended to support the foot’s arch and redistribute pressure evenly, slowing the deformity’s progression. Surgery is considered only when conservative treatments fail to relieve pain or the deformity significantly limits mobility, involving procedures like an osteotomy to reposition the misaligned bone.