Tailor’s bunion – bunionette

Tailor’s bunion, also known as a bunionette, is typically a prominence of the fifth metatarsal bone at the base of the little toe. Typically constant rubbing or poor alignment and mechanics lead to a painful bump at the base of the little toe.

A tailor’s bunion is similar to a regular bunion but in a different location. Typical bunions grow on the inside of the foot below the big toe. Tailor’s bunions grow on the outside of the foot at the base of the little toe.

Tailor’s bunions aren’t as common as regular bunions but they are similar in symptoms and causes.

Symptoms of Tailor’s bunion

The symptoms of tailor’s bunions include redness, swelling and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation.

Causes of Tailor’s bunion

The most common cause of pain with a tailor’s bunion is direct pressure to the lateral aspect of the 5th metatarsal head from tight shoes. Pressure from shoes will initially present as a red spot or blister over the 5th metatarsal head. If pressure persists, a bursa can form over the 5th metatarsal head. A bursa is a small fluid filled sac that forms in response to chronic pressure against the bone. Bursitis, or inflammation of the bursa, can significantly increase tailors bunion pain.

You can get this type of bunion from wearing poorly fitting shoes, such as narrow, high-heeled shoes. You’re more likely to get tailor’s bunion if you’ve inherited a structural foot problem from your parents. This problem could be that the bone in your little toe is in an abnormal position or the head of the bone is enlarged, which causes the bone to move out of place.

Other causes include:

• a foot that leans to the outside (inverted foot);
• loose ligaments in your foot;
• lower-than-normal fifth metatarsal bone;
• tight calf muscles.

A tailor’s bunion usually starts when you’re young and gradually gets worse with time. By the time you reach your 40s, the bunion may be painful.

Diagnosis of Tailor’s bunion

Your Foot and Ankle Clinic Podiatrist can diagnose tailor’s bunion just by looking at your foot. An X-ray can show problems with the bone of your little toe and help determine best treatment options.

Treatment of Tailor’s bunion

Treatment for tailor’s bunion typically begins with nonsurgical therapies. Your Podiatrist may select one or more of the following:

• Shoe modifications. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.
• Padding. Bunionette pads placed over the area may help reduce pain.
• Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
• Icing. An ice pack may be applied to reduce pain and inflammation. Wrap the pack in a thin towel rather than placing ice directly on your skin.
• Injection therapy. Injections of corticosteroid may be used to treat the inflamed tissue around the joint.
• Orthotic devices. In some cases, custom orthotic devices may be provided by a foot and ankle surgeon.
• Surgical Intervention. Surgery is often considered when pain continues despite the above approaches. In selecting the procedure or combination of procedures for your case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

Prevention of Tailor’s bunion

To prevent tailor’s bunion, always wear roomy, flexible shoes with a wide toe box. Avoid narrow, pointy shoes that squeeze your toes together. Each time you buy new shoes, get measured to make sure they’re roomy enough for your feet.

At the Foot and Ankle Clinic our highly qualified team of Podiatrists are all members of the Australian Podiatry Association and offer a combined 50 years’ experience. They are trained to diagnose and effectively treat Tailor’s bunion via a range of treatments.

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