Most people have heard of bunions—those big bumps on the side of your big toe, accompanied by the digit drifting sideways into its neighbor. However, the big toe isn’t the only one of the five susceptible to this kind of problem—although less common, a “mirror” version can affect your fifth toe, too.
This condition is known as a bunionette, or a tailor’s bunion, and features a similar package of causes, symptoms, and treatment options as its larger, more common relative. Despite its relatively smaller size, it can be quite troublesome and painful if not dealt with in a timely fashion.
Causes and Symptoms
As with bunions, we don’t know exactly why bunionettes form, but there is usually a genetic component that predisposes certain people to the condition. If your foot isn’t properly balanced to distribute forces evenly, the pinky toe may slowly drive out of alignment and form a bony spur at its base, on the outside of the foot. Frequent use of poor footwear, like high heels or tight shoes, can increase the likelihood of this formation as well as exacerbate the problem.
At first there may be no pain, and no other symptoms apart from the visual evidence of a small bump on the toe. However, without steps taken to control it, the growth will enlarge over time, and the toe will drift farther out of alignment, leading to painful friction between the protuberance and the inside of your shoe.
Unfortunately, the only way to fully “correct” a bunionette—that is, remove the bump and realign the toe—is surgery. That said, there are a number of less invasive strategies we can employ to help relieve the pain and prevent the condition from getting worse. We strongly recommend you try these first.
If the bump on the toe is small, treatment may be no more than a matter of finding a roomier, more comfortable pair of shoes. (For certain styles and materials, a shoemaker may even be able to adjust a current pair of shoes to give you more space). This is best combined with using soft pads placed over the bump in order to minimize painful pressure and friction on the area.
Other internal inserts may be helpful to reduce pain or redistribute weight. These can include toe spacers between your fourth and fifth toes, which helps to temporarily realign the digit, as well as custom orthotics tailored to your exact specifications.
Ice and oral anti-inflammatories are a good choice to deal with pain flare-ups; in more severe cases we may consider steroid injections to reduce inflamed tissues surrounding the metatarsal joint.
When conservative treatments do not bring intended relief, it may be time to consider surgery if you are healthy enough to do so. The procedure is highly successful on average and is usually performed on an outpatient basis in our office, but that doesn’t mean it’s risk-free—as always, follow all your doctor’s recommendations precisely in order to give you the best chance at a quick, successful recovery.
Specific techniques employed will depend on the size and severity of the deformity. Common procedures may include removal of soft tissues, removal of the bony growth, or cutting and realigning metatarsal bones (an osteotomy), and may require the use of plates or screw in some cases, particularly osteotomies.
The doctor will fill you in on what to expect for post-surgical care and recovery based on your health and the procedure selected. On average, full recovery typically lasts 3 to 6 months, with the protective cast or surgical boot coming off after 3 to 12 weeks.
You don’t have to suffer in silence—let Dr. Keith McSpadden of North Austin Foot & Ankle help you with your bunionette pain. Whether your answer lies in surgery, physical therapy, or just a better pair of shoes, we’ll help you find it and get you back on your feet. Give us a call today at 512-593-2949, or stop by in Cedar Park or Round Rock.