A tailor’s bunion, medically known as a bunionette, is a noticeable bony protrusion that develops on the outside edge of the foot at the base of the little toe. This bump forms specifically at the fifth metatarsophalangeal (MTP) joint, where the long fifth metatarsal bone connects to the pinky toe. This condition is similar to a traditional bunion, which occurs on the opposite side of the foot at the base of the big toe.
Defining Tailor’s Bunion and Key Symptoms
A tailor’s bunion represents a structural change where the fifth metatarsal bone shifts outward, causing the joint head to become prominent on the side of the foot. This outward deviation leads to a visible enlargement that can make the foot appear wider at the forefoot. The misalignment can also cause the little toe itself to angle inward toward the fourth toe, a condition called digitus quintus varus.
The most common symptoms stem from the friction and pressure this bump experiences inside footwear. Localized pain and tenderness at the site of the protrusion are frequently reported, especially when walking or standing for long periods. The skin covering the bony area may develop redness, or erythema, and inflammation due to the constant rubbing against shoes.
Over time, repeated irritation can cause the skin to thicken, leading to the formation of calluses or corns directly over the bunionette. An inflamed bursa can also develop, causing additional swelling and tenderness around the joint. Discomfort often worsens significantly when wearing shoes that have a narrow toe box or are otherwise ill-fitting.
Underlying Causes and Risk Factors
The development of a tailor’s bunion is attributed to a combination of inherited foot structure and external mechanical forces. Some individuals are born with a genetic predisposition, which may include a naturally wide forefoot, abnormal splaying of the forefoot bones, or an increased outward angle of the fifth metatarsal bone. These anatomical factors create a foot structure inherently more susceptible to the deformity.
Biomechanical issues, such as excessive inward rolling of the foot (overpronation) or abnormal weight distribution, can also place undue stress on the outer edge of the foot. This imbalance alters the mechanics of the foot, accelerating the shift in the fifth metatarsal bone.
The most common extrinsic risk factor is wearing footwear that compresses the toes, particularly shoes with narrow or pointed toe boxes and high heels. These shoes squeeze the toes together, forcing the fifth metatarsal head outward and irritating the joint. Activities that involve frequent pressure or repetitive motions on the forefoot, such as certain sports or prolonged standing, can also exacerbate the condition.
Non-Surgical Management Strategies
Initial management focuses on conservative methods designed to relieve pain and reduce inflammation. The most immediate and effective strategy is modifying footwear to accommodate the bony prominence. Patients should choose shoes with a wide, deep toe box and soft upper materials, which reduce friction and pressure on the bunionette.
Protective padding, such as bunionette shields or cushions, can be applied directly over the protrusion to prevent rubbing against the shoe lining. For temporary relief of pain and swelling, cold therapy can be applied to the area for 15 to 20 minutes several times a day. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, are often recommended to manage inflammation and discomfort.
Custom or over-the-counter orthotics may be used to address underlying biomechanical imbalances, such as overpronation, which contribute to the condition. These inserts help to properly distribute pressure across the foot. Simple physical therapy exercises, including calf stretches and toe exercises, can also improve flexibility and foot mechanics.