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Foot Health / Problems
Tailor's Bunion

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.

Condition Information

Tailor’s bunions are named as such because, historically, they frequently occurred in tailors who sat cross-legged on hard surfaces for prolonged periods. The outside aspect of tailors' feet, when sitting in this position, was subjected to excessive pressure, and constant rubbing led to a painful bump forming at the base of the fifth toe. Today, conventional footwear is the most common cause of tailor's bunions.

Contrary to popular belief, the bump is (typically) not extra bone or tissue, but rather a dislocation of the fifth metatarsophalangeal (MP) joint -- the joint at the base of the 'pinky' 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, immobilizing 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 characterizes 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.

In some cases, a tailor’s bunion may be confused with a bone spur that manifests on the side of your fifth metatarsal head.

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. See our shoe list for healthy footwear examples.
  • Incorporate a toe spacing product: A toe spacer, such as Correct Toes, 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.
  • Anti-inflammatory agents: Certain prescription drugs and dietary supplements may be helpful in reducing your bunion-related inflammation.
  • Injection therapy: Corticosteroid injections may help reduce inflammation around your affected joint.

In some advanced cases, a wedge of bone is removed from the base or back of your fifth metatarsal bone to allow for correction of a wide forefoot. Choosing this surgery before trying conservative care strategies, such as appropriate footwear modifications, is inadvisable, as this surgery is largely unnecessary. Review all possible treatment options with your podiatrist before choosing surgery to resolve your tailor’s bunion.

DR. RAY

In his 18 years as a podiatrist, Dr. Ray McClanahan has learned that most foot problems can be corr...
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