A painful enlargement on the outside of the foot near the base of the small toe is known as a Tailor’s bunion. Some medical practitioners refer to it as a bunionette, or a smaller version of the true bunion that occurs at the base of the large toe. This bony prominence or enlargement results in pain, local redness, and swelling, and is aggravated by various forms of shoe gear. A Tailor’s bunion can be quite painful, not only because the bone is enlarged and prominent, but also because the joint capsule can become inflamed, which can increase the pain level. In the most severe cases, a bursa (fluid filled sack) can develop between the skin and the bony enlargement, and increase the pain level.
This deformity received its name from medieval times when tailor’s sat all day cross-legged with the outside portion of their feet resting on the ground. This repetitive position resulted in the irritation of the 5th metatarsal head causing local redness, swelling, and pain. A Tailor’s bunion is the result of abnormal structural position of the front end of the 5th metatarsal, which is a hereditary condition. In other cases, the 5th metatarsal head is abnormally enlarged, which is also a hereditary condition. These hereditary structural deformities or bony enlargements can result in partial dislocation of the 5th toe. There are some patients who will also have pain, redness, and swelling at this joint because of abnormal bio-mechanical function of their foot, or as a complication of their systemic arthritis.
Narrow, pointed, ill fitting shoes are certainly the most common aggravating factors in irritating any abnormal structure or bony enlargement of this joint in our modern society.
The appropriate treatment for Tailor’s bunion cannot be determined without a proper history and physical evaluation by your Podiatric physician/surgeon. The determination of the type of deformity that a particular patient may have will require x-rays.
Conservatively, anti-inflammatory medication, padding, shoe modifications, and orthoses can all be attempted to eliminate an individual’s symptoms of Tailor’s bunion.
When conservative treatment has been unsuccessful, then surgical treatment may be available to the patient. Depending on the type of deformity that an individual may have, various surgical procedures are recommended in an attempt to remove the bony prominence, or realign the abnormal structure to allow for the normal function of the joint. These various treatment options should be discussed in detail with your Podiatric physician/surgeon.