The question of whether Tailor’s Bunion, also known as a bunionette, is hereditary is common for those experiencing this painful foot deformity. A bunionette is a prominent bony bump that forms on the outside of the foot, near the base of the little toe. While external factors often aggravate this condition, its origins are rooted in the inherent structure and mechanics of the foot.
Identifying Tailor’s Bunion
A Tailor’s Bunion is an enlargement of the fifth metatarsophalangeal (MTP) joint, which is where the little toe connects to the foot’s fifth long bone, the metatarsal. This prominence appears on the lateral, or outer, side of the foot. The distinctive name originates from centuries ago when tailors would sit cross-legged, causing chronic pressure and friction on the outer edge of their feet, which led to the development of a painful bump.
The primary symptoms include visible swelling and redness over the bony protrusion, localized pain, and the formation of thickened skin or calluses due to shoe irritation. The condition is sometimes called a bunionette because it is a smaller version of the more common bunion that affects the big toe.
The Role of Inherited Foot Structure
The condition itself is not directly inherited, but the underlying structural anatomy that creates a predisposition for a bunionette is passed down through family lines. X-rays often show an abnormally wide angle between the fourth and fifth metatarsal bones, known as an increased intermetatarsal angle. This structural variation makes individuals highly susceptible to the deformity.
Another inherited structural variation involves the shape of the fifth metatarsal bone itself. Individuals may have a bone that is naturally bowed outward or a fifth metatarsal head that is congenitally enlarged or shaped like a dumbbell. These subtle differences in bony architecture cause the bone to protrude more readily.
Loose ligaments, a condition known as ligamentous laxity, can also be an inherited trait contributing to the problem. This laxity allows the forefoot to spread or splay more easily under weight-bearing stress. When the foot splays, the fifth metatarsal bone shifts outward, increasing the prominence and irritation on the side of the foot.
External Factors That Increase Risk
While an inherited foot structure sets the stage, external forces often act as triggers that cause the bunionette to become symptomatic. The most significant external factor is footwear that is too narrow in the toe box. Constricting shoes, especially those with pointed toes or high heels, squeeze the forefoot, forcing the fifth metatarsal head outward and accelerating the deformity.
Abnormal foot mechanics or gait patterns can also contribute to the condition’s progression. For example, a foot that rolls inward excessively (pronation) or a foot that leans outward (supination) can cause abnormal loading and pressure on the outer edge of the foot during walking.
Management and Treatment Options
Treatment for a Tailor’s Bunion primarily focuses on relieving pain and preventing the deformity from worsening. The initial and most common non-surgical approach involves switching to shoes with a wide, deep toe box that accommodates the bony prominence without friction. Silicone pads or specialized padding can be placed over the bunionette to cushion it from shoe pressure.
Custom-made orthotic devices are often recommended to address the underlying biomechanical issues. These inserts redistribute pressure across the foot, helping to stabilize the area and reduce the effects of inherited loose ligaments or faulty foot mechanics. Anti-inflammatory medications and icing the area can also provide temporary relief from swelling and pain.
If the pain persists and severely limits daily activities despite all conservative measures, a surgical procedure may be considered. Surgery, often called a bunionectomy, is performed to correct the underlying structural problem. The procedure typically involves an osteotomy, which is a controlled cut in the fifth metatarsal bone to realign it and reduce the abnormal angle.