A bony prominence forming on the little toe is technically known as a Bunionette, or sometimes a Tailor’s Bunion, distinguishing it from the common bunion that affects the big toe joint. This condition develops when the fifth metatarsal bone, which connects the little toe to the rest of the foot, shifts outward from its normal alignment. The resulting bump on the outer edge of the foot causes discomfort, especially when wearing restrictive footwear.
Visual Characteristics of a Bunionette
The most visible sign of a bunionette is a firm bump located on the outside of the foot at the base of the little toe, at the fifth metatarsophalangeal (MTP) joint. This bony enlargement results from the metatarsal head shifting laterally, creating a protrusion that rubs against shoes. The skin over the prominence may appear red, inflamed, or swollen due to friction from footwear.
The little toe often angles inward, moving toward the fourth toe, which is part of the deformity. Pressure and rubbing against this bump can lead to the formation of calluses or corns on the skin directly over the bunionette. Pain and tenderness are common symptoms, often described as a burning or aching sensation that worsens when wearing tight shoes.
Factors Contributing to Development
Bunionette development is often a combination of inherited foot structure and external mechanical forces. Some people are born with a foot shape that predisposes them to this condition, such as a fifth metatarsal bone that angles outward or a wide forefoot. Structural factors like an abnormal walking pattern, such as excessive rolling inward of the foot (overpronation), can also place stress on the outside edge of the foot.
External factors, particularly footwear, accelerate the progression of the deformity. Shoes with a narrow or pointed toe box force the toes to squeeze together, pushing the little toe inward and the fifth metatarsal head outward. High-heeled shoes further compound the pressure by shifting more weight onto the forefoot. Repetitive pressure from certain activities, such as sitting cross-legged, can aggravate the condition.
Non-Surgical Management Strategies
Management focuses on reducing pain, inflammation, and preventing the deformity from worsening. The most effective step is modifying footwear by selecting shoes with a wide, deep toe box to eliminate pressure on the outer forefoot. Avoiding high heels and pointed styles is recommended, as these shoes exacerbate the misalignment and friction.
Protective padding, such as moleskin or specialized gel bunionette pads, can be applied to the bump to reduce rubbing against the inside of the shoe. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be used to manage acute pain and swelling. Applying an ice pack to the inflamed area helps to decrease local inflammation.
Custom orthotic inserts, prescribed by a specialist, can help redistribute pressure across the foot and improve underlying foot mechanics. While these non-surgical methods manage symptoms and slow the progression, they do not correct the underlying bony deformity itself. Maintaining a healthy body weight also reduces the load and stress placed on the forefoot joints.