It’s like the chicken and the egg: which comes first, the bunionette, or the tight shoes? Many people and medical professionals believe that shoes that pinch the ends of your toes into a pointed shape are the cause of this deformity. This idea is also how it got its other name, tailor’s bunion, since tailors often sat on the ground cross-legged, which put pressure on the toe. Recent research, however, suggests that faulty foot biomechanics may cause these bumps to form. It is believed that your gait—the way your foot bones function while walking—actually causes them to move out of position. You may never find a definite answer to this causal dilemma, but thankfully that doesn’t have to stop you from finding relief for your sore foot.
A bunionette occurs when the MTP joint by your littlest toe becomes misaligned. This is where the fifth metatarsal (MT) bone of your foot is joined to the proximal phalanx (P) bone in your fifth toe. With this deformity, the tip of the toe leans in toward your other toes, while the MTP joint moves out away from the foot, causing the bump. It is the same thing that happens when a bunion forms on your big toe.
The bump makes it hard to find shoes that fit, because most are not wide enough and rub against it, causing redness, swelling and pain. Heels are especially problematic, because they force your feet forward in the shoes, cramping your toes, while also putting more of your weight on your forefoot where the joints are located.
The friction from shoes can cause irritation of the bursa at this joint of your foot. It swells up and can be very painful. It may hurt while you are wearing the shoes, show redness in the area when you take them off, and then both redness and discomfort may subside as long as you are barefoot.
Bunionette Pain Relief
Since it is friction from shoes that leads to the pain, that is often the place we start when trying to treat the problem. Open sandals and soft fabric shoes that have a bit of give to them can often help with the discomfort. A pair with wider fronts that leave enough room for the deformity can be beneficial as well.
Other conservative treatments include comfort pads that surround the bump and cushion it from pressure, or a toe spacer that helps hold the little digit in a straighter line. If these are used, make sure your footwear is large enough for the added material, or the pressure will be even worse. If these do not relieve your pain, you may need to limit some of the time you spend standing or walking.
Is Surgery the Answer?
In a few patients, a surgical procedure may help, but this should not be considered unless other avenues have not brought relief. Either a part of the metatarsal that juts out may be removed, or the bone may be cut and repositioned and the ligaments holding the joint together tightened. Surgery is a big step and requires lengthy recovery times, so make sure you get all the information you need before making this decision.
If you notice the characteristic bump of a bunionette forming on the outside of your foot, give Atlantic Foot & Ankle Associates a call. As highly trained podiatrists, we will skillfully diagnose your foot problems and find the best way to treat them. We are also expert surgeons, if such a procedure is found to be necessary. You can reach one of our five locations by dialing the numbers below, or you can request an appointment online.