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What Is a Tailor’s Bunion?
Tailor’s bunion, also called a
bunionette, is an enlargement of
the fifth metatarsal bone at the base
of the little toe. The metatarsals are
the five long bones of the foot.
The enlargement that characterizes
a tailor’s bunion occurs at the
metatarsal “head,” located at the far
end of the bone where it meets the
toe. Tailor’s bunions are not as
common as bunions, which occur on
the inside of the foot, but both are
similar in symptoms and causes.
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.
Why do we call it “tailor’s bunion”?
The deformity received its name
centuries ago,when tailors sat crosslegged
all day with the outside edge
of their feet rubbing on the ground.
This constant rubbing led to a painful
bump at the base of the little toe.
Causes of a Tailor’s Bunion
Often a tailor’s bunion is caused by
an inherited faulty mechanical
structure of the foot. In these cases,
changes occur in the foot’s bony
framework that result in the
development of an enlargement. The
fifth metatarsal bone starts to protrude
outward, while the little toe
moves inward. This shift creates a
bump on the outside of the foot
that becomes irritated whenever a
shoe presses against it.
Sometimes a tailor’s bunion is
actually a bony spur (an outgrowth
of bone) on the side of the fifth
metatarsal head. Heredity is the main
reason that these spurs develop.
Regardless of the cause, the symptoms
of a tailor’s bunion are usually
aggravated by wearing shoes that are
too narrow in the toe, producing
constant rubbing and pressure. In
fact, wearing shoes with a tight toe
box can make the deformity get
progressively worse.
Diagnosis
Tailor’s bunion is easily diagnosed
because the protrusion is visually
apparent. X-rays may be ordered to
help the foot and ankle surgeon
determine the cause and extent of
the deformity.
Treatment:
Non-surgical Options
Treatment for tailor’s bunion typically
begins with non-surgical therapies.
Your foot and ankle surgeon may
select one or more of the
following options:
• Shoe modifications. Wearing the
right kind of shoes is critical.
Choose shoes that have a wide
toe box, and avoid those with
pointed toes or high heels.
• Oral medications. Nonsteroidal
anti-inflammatory drugs
(NSAIDs), such as ibuprofen, may
help relieve the pain and
inflammation.
• Injection therapy. Injections of
corticosteroid are commonly used
to treat the inflamed tissue
around the joint.
• Padding. Bunionette pads placed
over the area may help reduce
pain. These pads are available
from your foot and ankle surgeon
or at a drug store.
• 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.
When Is Surgery Needed?
Surgery is often considered when
pain continues despite the above
approaches. Surgery is highly
successful in the treatment of
tailor’s bunions.
In selecting the procedure or
combination of procedures for your
particular 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.
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