Bunionette - Tailor's Bunion
A bunionette is very similar to a bunion, but a bunionette is a bony prominence on the outside of the foot at the base of the little toe, as opposed to the inside of the big toe. Bunionettes may coexist with bunions as they tend to have the same root causes.
A bunionette is also known as a Tailor's bunion because centuries ago it was commonly developed in tailor's who sat cross-legged on the floor for long periods of time with the outside edges of their feet rubbing on the ground. The constant pressure on that spot led to the development of a painful bump at the base of the 5th toe.
(Typical) Symptoms
Outwards protrusion/ enlargement at the base of the 5th toe
Signs of redness or swelling around the baby toe
Callusing
Pain in and around the 5th toe joint
Pain when wearing certain types of footwear, with relief upon the removal of irritating footwear
Medial deviation of the 5th toe (shift of the 5th toe towards the other toes)
(Some potential) Causes:
Wearing poorly fitting shoes - tight fitting shoes (specifically those to narrow through the forefoot), or shoes, such as those with a pointed toe-box or high heels, place extra pressure on the forefoot and push the 5th toe inwards. Ill fitting footwear is the biggest contributor to the formation of bunionettes; it's also why bunionettes occur much more often in women versus men.
Excessive pronation - abnormal pronation (arch drop) due to hypermobility when standing or walking, causes the forefoot to splay or slide outward leading to increased pressure at the base of the 5th toe.
High Arched Feet - those with high arches have less surface area in contact with the ground to spread forces throughout the foot, therefore increasing the pressure at the base of the 5th toe.
Arthritis - certain types of arthritis (such as rheumatoid arthritis) can damage the joint leading to misalignment.
Structural variations - those with bowing in their 5th metatarsal or a short 5th metatarsal can be at risk for developing bunionettes.
Certain foot positions that are maintained over long periods of time - such as sitting cross-legged, increase the pressure and load at the base of the 5th toe.
Conservative Treatment:
Appropriate selection of properly fitting footwear to aid in offloading and pressure relief of the bunionette. Tight fitting footwear should be avoided, as it is a contributing factors to the development of a bunionette. Shoe width is the most important as a bunionette generally hits at the widest part of the foot; therefore the widest part of your foot should sit at the widest part of the shoe with enough width that the upper part of the shoe is not pulled tight. A tight fitting shoe will exert pressure on the bunionette, leading to irritation. Shoes with pointed toes should be avoided; look for footwear with a rounded or square toe box. A deep and wide-toe box is best, ideally with a seamless upper throughout the forefoot area. Seams don't stretch but materials such as leather, suede and mesh will give slightly.
Check the fit of your shoes but taking the insole out of your shoe and placing your foot on top of it, if your foot falls outside the edge of the insole the shoe isn't the correct shape for you.
High heels can cause more pressure to be shifted forwards onto the ball of the foot, which can cause increase pressure and pain on the bunionette. Decrease heel height and duration of high heel wear to help offload the bunionette.
Orthotics can be effective at helping to off-load the bunionette by redistributing load and relieving pressure from sensitive areas by reducing stress and biomechanical load on the joint.
Shoe stretching, footwear modification and toe spacers or guards can be effective at relieving pain.
