A tailor’s bunion, medically known as a bunionette, is a common foot deformity characterized by a bony bump that forms on the outside of the foot at the base of the little toe. This condition is a structural misalignment of the fifth metatarsal bone, which connects to the smallest toe, causing it to protrude laterally. The term “tailor’s bunion” originated because tailors often sat cross-legged, placing constant pressure on the outer edge of the foot, eventually leading to this painful enlargement. While not as frequently discussed as big toe bunions, a bunionette can cause significant discomfort and make wearing certain types of footwear difficult. This article explores the physical characteristics, underlying causes, and effective strategies for treatment and relief.
Identifying This Foot Condition
The defining characteristic of a tailor’s bunion is the noticeable bony prominence located on the outer side of the forefoot, specifically at the head of the fifth metatarsal bone. This joint is where the little toe meets the rest of the foot, known as the fifth metatarsophalangeal (MTP) joint. The enlargement is often accompanied by the little toe shifting inward toward the fourth toe, indicating underlying joint misalignment.
Individuals often experience localized pain, tenderness, and inflammation directly over the bony bump. The skin in this area may appear red or swollen, especially after prolonged activity or when wearing constricting shoes. Friction from footwear can cause the skin to thicken, leading to the development of calluses or corns directly over the protrusion.
A sensation of pressure or burning in the joint is also common, which can make standing or walking painful. The condition may affect a person’s gait as they shift weight off the painful area. An x-ray confirms the diagnosis by revealing the degree of bone misalignment and the size of the bony outgrowth.
What Causes Tailor’s Bunions
The development of a tailor’s bunion is often attributed to a combination of mechanical forces and inherited foot structure. A significant external factor is the consistent use of tight, narrow, or poorly fitting footwear. Shoes with a narrow toe box or high heels force the toes to crowd together, applying excessive pressure to the fifth metatarsal head and pushing the little toe inward.
Natural foot mechanics and anatomy also play a substantial role in susceptibility. The condition is frequently linked to an inherited faulty mechanical structure where the fifth metatarsal bone naturally protrudes outward more than usual. This inherent structural issue, such as a wide forefoot, creates a predisposition for the deformity to occur.
Specific biomechanical irregularities, like an inverted foot that leans to the outside or excessive pronation during walking, increase stress on the outer edge of the foot. Splaying of the forefoot or loose ligaments can further destabilize the fifth MTP joint, encouraging the lateral shift of the metatarsal bone. In some cases, the bunionette is not a structural misalignment but rather a bony spur, which is an outgrowth of bone on the side of the metatarsal head.
Treatment and Relief Strategies
Initial management focuses on conservative, non-surgical methods aimed at relieving pressure and reducing inflammation. The first step involves changing footwear, choosing shoes with a wide, deep toe box that provides ample room for the toes. Avoiding narrow, pointed shoes and high heels is important to prevent further irritation and progression of the deformity.
To cushion the painful area, over-the-counter bunionette pads or silicone spacers can shield the bump from shoe friction. Applying ice for 15 to 20 minutes helps reduce swelling and provides temporary pain relief. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may also be used to manage pain and localized inflammation.
For individuals with underlying foot mechanics issues, custom-made orthotic shoe inserts can improve foot alignment and redistribute pressure away from the fifth metatarsal head. A healthcare provider may also suggest taping the toe to maintain proper alignment or recommend physical therapy exercises to strengthen the foot and calf muscles.
If conservative treatments fail to provide adequate relief, or if the bunionette becomes severely painful and affects mobility, surgical intervention may be considered. The goal of surgery, often a bunionectomy or osteotomy, is to physically realign the fifth metatarsal bone and remove the bony prominence to restore normal foot function.