Bunions & Bunionettes

What Are Bunions & Bunionettes?

Bunions and bunionettes are medical disorders of the feet and one of the most common reasons for painful toes. Bunionettes are also known as the ‘Tailor’s bunion.

Bunion: A bunion is a prominence over the joint where the big toe joins the rest of the foot (1st metatarsophalangeal joint). A bunion usually develops due to hallux valgus deformity, which is when the 1st metatarsal bone gradually deviates inwards, towards the opposite foot. The big toe moves in the opposite direction, towards the lesser toes, and this leaves the head of the 1st metatarsal bone prominent under the skin.

Bunionette: A bunionette is a prominence over the joint where the little toe joins the 5th metatarsophalangeal joint. These conditions can become extremely painful over a long period of time and make shoe fit difficult.

How Do Bunions & Bunionettes Occur?

The most common cause is imbalance of forces on the toe, which is probably present from early in life, and this results in a gradual progression of deformity over time.

Constrictive or pointy-toed shoes can exacerbate bunions and bunionettes and lead to further pain and deformity. Certain conditions such as rheumatoid arthritis and gout may also cause bunions.

The main causes of bunions and bunionettes are:

Wearing high heeled, pointy or narrow shoes that result in toes being pushed together.
Inherited structural defects of the foot anatomy.
Foot injuries.
Arthritis.
Poor biomechanics, usually over pronation.

What Are the Symptoms of Bunions?

Swelling
Pain and tenderness around the big toe
Turning of big toe towards the adjacent toe
Change in the shape of the foot
A bony mass at the joint surface of the big toe
Pain and discomfort while walking
Restricted movements of big toe

What Are the Treatments for Bunions?

Prescribing broader-toed shoes that are comfortable and fit properly to reduce the pressure against the bunion and other toes.
Medications to help alleviate pain and associated symptoms.
Ice packs to reduce inflammation.
Use of splints to protect and alleviate painful foot bunions by re-aligning the toe.

Surgical method:

If bunions become symptomatic and painful, then surgical correction by an orthopaedic foot & ankle surgeon may be needed. The type of surgery required can depend on the severity of the bunion and any associated conditions such as diabetes or rheumatoid arthritis.

What if Bunions & Bunionettes Are Untreated?

If left untreated, bunions and bunionettes can become increasingly painful over time.

The sequelae of bunions can include:

Hammertoe formation affecting the lesser toes
Metatarsalgia, which is tenderness and swelling under the balls of the foot
Bursitis, which is build-up of an inflammatory fluid-filled sac next to the bunion
Ulceration and infection of the skin over the bony bunion bump