Pain in your toe or the ball of your foot – bunionette

What is a bunionette?

A bunionette or Tailor’s bunion is a deformity that causes a bony lump to develop around the small toe joint on the outside of your foot. Tailor’s bunions are essentially a smaller version of a bunion, but less common.

The bony lump, that can also include soft tissue, can make your foot wider, making it more difficult to find footwear that is comfortable. Tight fitting footwear can rub the bunionette resulting in your skin becoming red, painful and swollen.

In some cases the skin can thicken or blister, or a bursa can develop over the bony lump which can become inflamed and painful. A bursa is a small fluid filled sack that is found between the bone and the soft tissue and helps to increase shock absorption and reduce friction.

Signs and symptoms of a bunionette 

You may experience any or all of the following:

• bony lump on the outside of your foot at the little toe joint
• deviation of the small toe towards the fourth
• toe pain and swelling around the bony lump
• inflamed, swollen or hard skin over the bony lump
• difficulty in finding comfortable fitting footwear.

What causes a bunionette?

It is believed that bunions and bunionettes run in the family with the shape of the bones in your feet playing a role. Poorly fitting footwear is also a contributing factor. If shoes are too tight this puts pressure on the joint, bursa and surrounding nerves causing pain.

Other contributing factors include:

• previous injuries/trauma to your toe joints
• hypermobility/flexible joints
• age
• inflammatory arthritic conditions, such as rheumatoid or psoriatic arthritis
• tightness in the muscles in the back of your leg
• neuromuscular conditions such as stroke, cerebral palsy, multiple sclerosis or Charcot-Marie tooth syndrome.

What can I do to relieve the pain of a bunionette? 

There are a number of things you can do to reduce the pressure on your bunionette – this will not correct the deformity or change the size or shape of the bunionette, but it will help to relieve pain. Making changes to your lifestyle so you reduce aggravating activities is key. Only you can do this.

Things to try:

• raising your foot on a stool and resting it when you can
• putting an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every two to three hours
• shoes with cushioned heels and good arch support
• insoles in your footwear
• regular stretching and foot exercises
• exercises which put no pressure on your feet, such as swimming
• losing weight if you’re overweight or obese.

Things to avoid:

• walking or standing for long periods
• wearing high heels or tight, pointy shoes
• wearing flip-flops or backless slippers
• walking barefoot on hard surfaces.

What shoes should I wear if I have a bunionette?

It’s important to choose footwear that is wide and deep enough to accommodate your bunionette, with a softer material on the upper/ top section. Softer materials can mould around the deformity more easily than hard leathers.

If your footwear is too narrow it will rub on the bunionette causing the surrounding skin to become red, swollen and in some cases to thicken or blister. Find out more on our footwear advice page including how to check if shoes fit.

Padding

If the skin or bursa over over the bunionette becomes inflamed or blistered, use a pad made from fleecy web or semi compressed felt to reduce the friction. If the skin is broken cover with a plaster.

Ankle, foot and toe rehabilitation exercises

The video exercises shown below will help to improve your pain over a period of time. Watch the video first, then try the exercise. There are six videos to try – go through to the next one below by clicking the arrow on the right of the video. All videos provided and shared with kind permission of, and thanks to, the Musculoskeletal Podiatry team at NHS Lanarkshire.

You need the use of a clear space of wall, a small towel, a small plastic bottle of water, a sports resistance band and a sports therapy ball. If you do not have a sports resistance band or sports therapy ball (also known as a soft spiked massage ball) these can be purchased relatively inexpensively online. If cost is an issue, focus on the exercises which do not use that equipment.

Important – pain levels: the NHS uses a pain scale where pain is measured from 0-10 (zero being no pain and 10 representing the worst pain you could imagine).

If you can identify the level of pain you are experiencing, you will find out if you are in the green, amber or red zone.

When you are completing your rehabilitation exercises it is often best to work within the green (and sometimes amber zones depending on what you deem is an acceptable level of pain) both during the exercises and within 48 hours of completing your exercises.

The best way to move down to the green zone is by pacing and spacing your activity. If you find yourself in the red zone you are likely pushing yourself too hard and the pain may flare up.

If you notice a large increase in your pain after doing the exercises, or you find that after six to twelve weeks there is no noticeable changes in your day to day symptoms, then please contact your GP or self-refer to our MSK podiatry team.