A Tailor’s Bunion is a common foot deformity affecting the outside border of the foot, often causing discomfort and difficulty wearing shoes. It appears as a noticeable prominence near the base of the little toe (the fifth digit). This bump is fundamentally a misalignment of the bones in the forefoot.
What Is a Tailor’s Bunion?
The Tailor’s Bunion is medically known as a Bunionette. It represents a bony enlargement at the joint where the little toe meets the foot. Anatomically, this bump is an enlargement of the head of the fifth metatarsal bone, the long bone connecting the ankle area to the base of the little toe. The condition is structurally similar to a regular bunion (Hallux Valgus), which occurs on the medial side of the foot at the big toe joint. In a Bunionette, the fifth metatarsal head protrudes outward, and the little toe may angle inward toward the fourth toe. This bony protuberance becomes irritated and inflamed when it rubs against footwear, causing redness, swelling, and pain.
The Origin of the Name
The name “Tailor’s Bunion” is a relic of occupational history, originating from the traditional working posture of European tailors. Before modern sewing machines and ergonomic furniture, tailors often sat cross-legged on the floor or a low bench to perform their work. This position forced the outside edge of their feet to press firmly against the ground. This prolonged, repetitive pressure was concentrated directly on the head of the fifth metatarsal bone. The constant friction and mechanical stress over years caused the bone to become irritated, inflamed, and develop the characteristic bony enlargement, linking the condition to the trade.
Current Causes and Risk Factors
The condition develops today due to a combination of external and structural factors in the general population. The most common modern cause is wearing footwear that is too narrow or pointed in the toe box. Shoes that tightly compress the forefoot place excessive pressure on the outside of the foot, forcing the fifth metatarsal head to protrude and the little toe to deviate inward. High-heeled shoes also contribute by shifting body weight forward and increasing pressure on the toes.
Inherited foot structure is a significant risk factor, as some people are predisposed due to bone alignment. Individuals with a splayed forefoot, a naturally wide foot, or a fifth metatarsal bone already angled outward are more susceptible to developing the deformity. Biomechanical issues, such as excessive foot pronation (where the foot rolls inward while walking), can also place abnormal stress on the lateral side of the foot.
Treatment Options
Initial management focuses on conservative methods to reduce pressure and relieve pain. The most important step is switching to wider shoes with a deep toe box that does not compress the forefoot. Protective padding over the bony prominence helps prevent friction and irritation from footwear. Anti-inflammatory medications and ice application manage pain and swelling during flare-ups. For underlying mechanical issues, custom orthotic inserts may be recommended to rebalance the foot and slow the deformity’s progression. If conservative treatments fail, or if the deformity is severe, surgical correction may be necessary. The most common procedure is an osteotomy, which involves cutting and realigning the fifth metatarsal bone to restore the foot’s structure.