By Dustin L. Kruse, DPM
If you are the type of person who likes things to be neat and organized with everything in its place, developing a bunionette can be frustrating. That bump sticking out by your little toe is not supposed to be there; it looks strange, makes it hard to find shoes that fit, and can be quite painful. Also called a tailor’s bunion, this toe deformity can limit your mobility and disrupt your life. Isn’t it time to do something about it?
Why Is My Little Toe Joint Sticking Out?
A bunionette forms the same way as a regular bunion does. It usually starts with a genetic foot structure that causes your gait to be a little “off.” Landing just a bit wrong with each step can gradually move your bones out of alignment. The tip of the toe moves toward the center of the foot, and the joint by the foot bumps out the other way. This toe deformity is much more common in women; wearing pointed shoes that cramp your toes in these awkward positions definitely contributes to the problem.
I See the Bump, But Why Does It Hurt?
The condition was originally called a tailor’s bunion, caused by their cross-legged sitting pattern that put pressure on the outsides of their feet. The bony metatarsophalangeal joint (MTPJ) would move out of alignment and rub against the ground. The spot where it rubbed would develop redness, swelling, and pain in the surrounding soft tissue.
These days, if you have a bunionette, the discomfort is caused by the bump rubbing against your shoes. That constant friction with each step irritates the soft tissue around the joint, causing inflammation and pain, but you can also form extra bone on the outside of the metatarsal head, which increases the pressure even more.
What Can I Do to Relieve Bunionette Pain?
You can try conservative treatments, such as buying shoes that are wide and tall enough so your toes are not cramped. You can place a donut-shaped pad over the bump, to relieve the pressure from your shoes. You can also try massage, manipulation, and icing to reduce discomfort and swelling and keep your toe flexible.
We can also recommend medications for the pain and inflammation—either oral or injected—or fit you with custom orthotics to relieve pressure on the joint or correct your gait problems. When you have tried all of these for several months and your sore toe is still limiting you, it is time to consider surgery.
Here Are the Details about Bunionette Surgery
First, surgery is not for everyone, every time. If there is any sign of infection in the toe or if your blood flow is not good (which slows down the healing process), it might be best not to perform surgery at this time.
Second, it is not a major surgery. You will usually have the procedure done as an outpatient and go home the same day. The procedure could be as simple as just removing the soft tissue (extra skin and bursa), or shaving off some of the extra bone that has grown. More extensive methods involve cutting and realigning the curved bone or joint and holding it in place with pins or screws.
Third, you will need to take time to recover. This means following our post-surgery instructions to a T, including wearing a protective boot, keeping weight off, caring for the incision, and elevating your foot to reduce swelling. You will need to watch for complications like infection or bleeding, but these are rare. The swelling may not completely go down for many months.
Finally, your stitches will usually come out after 2 or 3 weeks, but that is not a signal to resume full activity. We will let you know what knee and ankle exercises to do, prescribe physical therapy if needed, and guide you gradually back to your normal life.
If you have a bunionette that is bothering you, call Rocky Mountain Foot & Ankle Center at (303) 423-2520 and set up an appointment in Wheat Ridge, Golden, Evergreen, or Granby, CO. We’re ready to help you say goodbye to toe pain for good.
Photo credit: marin via freedigitalphotos.net
