A tailor’s bunion, also known as a bunionette, is a bump or prominence on your fifth metatarsal bone, at the base of your little toe. Your metatarsal bones are the five long, thin bones in your mid-foot that attach to your toes. Tailor’s bunions are less commonly experienced than regular bunions, or prominences that develop on the inside aspect of the base of your big toe.

Causes and Symptoms

Inappropriate footwear, especially shoes that are improperly fitted, is a main cause of tailor’s bunions. The tapered toe boxes of most conventional shoes push your fifth toe toward your fourth toe, immobilising your little toe in this deformed position. Your fifth toe, when it is held in this position, is more susceptible to trauma from your shoe. Most shoes available to consumers are not sufficiently wide for the average foot, especially in the toe box.

A tailor’s bunion also may be caused by inherited mechanical problems in your feet. Alterations in your foot’s bony alignment may cause the enlargement that characterises this health problem; that is, your fifth metatarsal bone begins to protrude on the outside aspect of your foot while your fifth toe shifts toward your foot’s midline, creating a bump in this area that is irritated when your shoe rubs against it.

A tailor’s bunion causes the same symptoms as a regular bunion. Common signs and symptoms associated with a tailor’s bunion include:

  • Pain at the site of your enlargement
  • Redness
  • Swelling

Tailor’s bunion-related symptoms are often made worse by wearing shoes that possess narrow toe boxes, which rub against your prominence and irritate the soft tissues underneath your skin in your affected area.

Treatment

Most tailor’s bunions can be treated conservatively by restoring proper alignment of your foot bones. Some strategies for resolving this health problem include:

  • Avoid footwear that squeezes or pinches your forefoot. Choose shoes that possess a wide toe box and little or no heel elevation. Ask your Podiatrist for footwear advice.
  • Incorporate a toe spacing product: A toe spacer, places your fifth toe in a proper orientation, in-line with your fifth metatarsal and splayed away from your fourth toe. When worn regularly over a period of time, a toe spacer can reduce your Tailor’s bunion. When using a toe spacer, it’s imperative to wear only footwear with a wide enough toe box to easily incorporate your splayed toes.
  • Icing: Icing your affected area may reduce your pain and inflammation. Always wrap your ice pack in a thin towel when icing your problem area.
  • Padding: Pads, especially bunionette pads, may help decrease your pain.
  • Over-the-counter oral non-steroidal anti-inflammatory medications such as Ibuprofen (Advil) can help reduce the pain and inflammation of the bunion.
  • Injection therapy: Corticosteroid injections may help reduce inflammation around your affected joint.
  • If your podiatrist believes it is necessary to remove the deformity or if conservative treatments options have not provide adequate symptom relief, surgery may be recommended.  Surgery can be straight forward, such as shaving or reducing the bone prominence in order to lessen pressure on your bunion from footwear. In some cases, cutting or separating the 5th metatarsal (small toe) so it can be properly realigned is the best way to improve your overall foot mechanics.
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