Bunionettes

Definition

Bunionette: A bump or prominence on the fifth metatarsal bone, at the base of the little toe.

General Info

Bunionettes are less common than regular bunions (bumps or prominences that develop on the inside part of the base of the big toe), though they are similar to a true bunion in their appearance and symptoms. Bunionettes are often called tailor’s bunions because they frequently occur in tailors who sit cross-legged on hard surfaces for prolonged periods. The outside aspect of the feet, when sitting in this position, is subjected to excessive pressure, and constant rubbing of the area against the ground leads to the formation of a painful bump at the base of the fifth toe. Women who wear pointed-toe shoes or high heels are more likely to develop this condition, due to the extreme pressure on the outside part of the foot caused by fashion footwear.

Signs & Symptoms

Common signs and symptoms of bunionettes—in addition to the angular deformity at the fifth metatarsophalangeal joint—include:

• Pain
• Swelling
• Redness

Bunionette symptoms are often made worse by wearing shoes that possess tapering toe boxes, which rub against the prominence and irritate the soft tissues underneath the skin of the affected area.

Possible Causes

Inappropriate footwear is the leading cause of bunionettes in our society. The tapering toe boxes of most conventional shoes push the fifth toe toward the fourth toe, immobilizing the little toe in this deformed position. The fifth toe, when it is held in this position, is more susceptible to trauma from the shoe. Most shoes available to consumers today are not sufficiently wide for the average foot, especially in the toe box, or they have a non-expansile upper that fails to accommodate any sort of bony prominence.

Other possible causes of a bunionette include certain arthritic conditions, such as rheumatoid arthritis or psoriatic arthritis, that damage bone and lead to joint misalignment. Certain neuromuscular diseases may also cause a bunionette, due to the resulting imbalance in the muscles and tendons that act on the foot and the subsequent deformation of foot structure. Leg length discrepancies and foot trauma or surgery may also be causative factors for this condition. In some cases, a bunionette may be confused with a bone spur that arises on the side of the head of the fifth metatarsal bone.

Helpful Strategies

Most bunionettes can be treated conservatively by wearing shoes that allow the toes to splay the way nature intended. Choose foot-healthy shoes that possess a wide toe box and little or no heel elevation or toe spring. Other strategies or tools for treating bunionettes include:

• Padding: Pads, especially bunionette pads, may help decrease any pain.
• Anti-Inflammatory Agents: Certain dietary supplements may be helpful in reducing bunion-related inflammation.
• Toe Spacers: A toe spacer, such as Correct Toes, places your fifth toe in its proper orientation; that is, aligned with the fifth metatarsal bone and splayed away from the fourth toe. When worn regularly over a period of time, Correct Toes can help eliminate a bunionette. When using Correct Toes, it’s extremely important to wear only footwear with a wide enough toe box to easily accommodate the device.

In certain advanced cases, a surgeon may remove a wedge of bone from the base or back of the fifth metatarsal. However, surgery for this foot problem is usually unnecessary. For most people, an effective and noninvasive first line of approach to treating bunionettes involves wearing men's or women's foot-healthy footwear and using Correct Toes toe spacers. Review all possible treatment options with a foot health professional before choosing surgery to correct a bunionette.