Yes, a bony prominence can form on the little toe, medically known as a bunionette or Tailor’s Bunion. Unlike the common bunion, which affects the joint at the base of the big toe, the bunionette occurs on the opposite side of the foot. It is a deformity that develops over time, creating a noticeable bump on the outer edge of the foot near the pinky toe. Recognizing this specific term helps distinguish it from the more frequently discussed big toe bunion.
What is a Bunionette
A bunionette is an anatomical deformity characterized by the lateral deviation or enlargement of the fifth metatarsal head, the long bone at the base of the little toe. The result is a painful, bony protrusion on the side of the foot. This bump is often accompanied by redness, swelling, and tenderness due to constant friction against footwear.
The historical name, Tailor’s Bunion, comes from an old practice where tailors sat cross-legged, putting chronic pressure on the outer edge of the foot. This pressure caused the joint to become irritated and shift over time. While the cause is often related to modern footwear, the site of the deformity is always the fifth metatarsophalangeal (MTP) joint.
Causes and Contributing Factors
The primary mechanism leading to a bunionette is the outward shifting of the fifth metatarsal bone or a misalignment of the joint itself. Heredity plays a significant role, as some individuals inherit a foot structure, such as a naturally prominent fifth metatarsal head or abnormal foot mechanics. A wider forefoot or a specific foot type can increase the likelihood of the fifth metatarsal splaying outward.
External factors, particularly footwear, are major contributors to the progression of this deformity. Shoes that are tight, narrow, or pointed force the toes together, placing excessive pressure directly onto the fifth metatarsal head. High-heeled shoes exacerbate the issue by shifting the body’s weight forward, increasing the compressive force on the forefoot. Repetitive stress on the outer part of the foot, common in certain athletic activities, can also inflame the area and contribute to the formation of the bump.
Managing Symptoms Without Surgery
Conservative, non-surgical management focuses on reducing pressure and alleviating pain associated with friction and inflammation. The most immediate and effective step is switching to appropriate footwear, specifically shoes with a wide or square-shaped toe box. Avoiding narrow shoes prevents the constant rubbing that irritates the bony prominence.
Protective padding, such as over-the-counter gel or foam bunionette pads, can be placed directly over the bump to cushion it from the inside of the shoe. Applying ice packs helps reduce localized swelling and acute pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used for a short duration to manage pain and reduce inflammation in the joint. Custom or over-the-counter orthotic inserts can also help by redistributing pressure across the foot, correcting biomechanical imbalances.
When Professional Intervention is Necessary
A patient should seek professional evaluation when the pain becomes chronic, interfering with daily activities like walking or standing, or if conservative treatments fail to provide relief after several months. Persistent inflammation, a progressively worsening deformity, or an inability to find comfortable footwear are clear indicators that medical intervention is needed. A foot specialist will perform a physical examination and order X-rays to assess the extent of the bone misalignment and identify any concurrent foot issues.
If non-surgical methods are unsuccessful, surgery may be recommended to permanently correct the deformity. The two main surgical categories involve either an exostectomy, the simple shaving of the bony prominence, or an osteotomy, which involves cutting and realigning the fifth metatarsal bone to fix the underlying structural issue. The choice of procedure depends on the severity of the bunionette and the individual’s foot mechanics, with the goal being to relieve pain and restore proper foot function.