What Is A Tailor’s Bunion?

Footworks September 2009
By Dr Alexandra Buk

What is a Tailor’s Bunion?

Tailors 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, 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 tailor’s sat cross-legged all day with the outside edges 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 these spurs develop.

Regardless of the cause, the symptoms of a tailor’s bunion are usually aggravated by wearing shoe 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.

Tailor’s bunion is easily diagnosed because the protrusion is visually apparent. X-rays may be ordered to help the podiatrist determine the cause and extent of the deformity.

Treatment of Tailor’s Bunion

Treatment for tailor’s bunion typically begins with non-surgical therapies. Your podiatrist may select one of the following options:

Shoe modifications. Wearing the right type of shoe 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 podiatrist or 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 the ice directly against the skin.

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 procedures or combination of procedures for your particular case, the podiatric surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. Most procedures allow immediate weight-bearing in a surgical shoe or boot, and the goal is return to full activity as quickly as possible.

Extra tip from Dr Buk: If your tailor’s bunion “bump” (or any spot that protrudes on your foot) hurts when you are wearing a leather shoe without hose or socks, try rubbing some petroleum jelly, or Vaseline, on the bump. This cuts down on the friction and keeps corns and calluses from forming as quickly!