What Is a Bunionette?

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If you have a painful bump on the outside of your foot just below the little toe, you probably have a bunionette. A bunionette is a prominence of the fifth metatarsal bone where it meets the bone of the little toe; it is often associated with the little toe tuning inward. Bunionettes are similar to bunions, which are protrusions that occur on the inside of the foot below the big toe.

In most cases, narrow footwear can exacerbate the problem, and pain relief is achieved by choosing footwear that is wider in the toe area.

Also Known As

Bunionettes are also called tailor's bunions. The name comes from the fact that tailors were known to have this condition because of the posture they kept while working.

Symptoms of a Bunionette

A bunionette may start as a painless bump on the outside of the foot just below the fifth toe. The area may become swollen, red, and painful. A hard corn or callus may grow over the bump. Over time, the bump may grow and the little toe may be forced to turn inward.

Typically, pain only occurs when wearing shoes that rub on the irritated prominence. You probably won't experience pain when you switch to shoes with a wide toe box, you are barefoot, or you're wearing sandals or flip-flops.

People who have bunionettes often also have bunions as well.

Bunionettes can cause more significant problems if the irritation causes breaks in the skin. In these instances, an infection can occur and cause further problems. This is especially a concern if you have diabetes.

Causes

There are both extrinsic and intrinsic causes for bunionettes:

  • Extrinsic causes of bunionettes are those that place external pressure on the forefoot. This pressure is usually due to footwear, but can stem from other causes.
  • Intrinsic causes of bunionettes are congenital problems that lead to a bowing of the long bones of the forefoot. In patients with this condition, the bone projects slightly outward, causing the bunionette. Only a small percentage of patients with bunionettes develop them due to intrinsic causes alone.

Footwear

Like bunions, most bunionettes are caused by an inherited problem with the structure of the foot that is aggravated by poor choices of footwear.

Specifically, wearing footwear that constricts the forefoot such as high-heels or shoes with narrow, pointed toeboxes is the biggest risk factor for developing a bunion or bunionette.

Therefore, bunionettes are much more common in women than in men, although cowboy boots can be to blame for both men and women.

Diagnosis

A self-check of your symptoms can often lead to an informal diagnosis.

If you have ongoing pain or are at risk of an infection due to broken skin (especially if you have diabetes), it is good to seek a formal diagnosis from a healthcare provider. You can start with your primary care physician or visit a podiatrist or orthopedic specialist.

The diagnosis can usually be made by performing a physical examination and reviewing a patient's history. Sometimes, an X-ray will be done to look for the extent of damage.

Treatment

Treatment of a bunionette should always focus on non-surgical options. These include:

  • Changing footwear
  • Wearing shoes with a wider toebox or sandals
  • Padding the bunionette

When you look for the right footwear, make sure the ball of your foot fits well in the widest part of the shoe. This may mean you need to buy a larger size of shoe or a wide shoe.

Over-the-counter bunion cushions can help, but they need to be used with shoes that have a wide-enough toe area to allow for extra padding without constricting your foot further.

When the bunionette is inflamed, you can apply a cold pack for 20 minutes at a time, several times per day. Be sure not to apply ice or a frozen pack directly to your skin. A nonsteroidal anti-inflammatory medication (NSAID) such as Advil (ibuprofen) or Aleve (naproxen) can help reduce swelling and relieve pain.

Surgery

In the few patients who have persistent symptoms despite these treatments, surgical correction of a bunionette is an option. Surgery is performed to realign the bone so that it does not point outward.

This is usually performed as an outpatient procedure, but it can have a long recovery period.

 

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Article Sources
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  5. American College of Foot and Ankle Surgeons. Tailor's bunion (bunionette). 2019.

  6. American Academy of Orthopedic Surgeons. Bunion surgery. Updated February 2016.