What is a Tailor’s Bunion (bunionette)?  

Tailor’s bunion, commonly referred to as a bunionette, is a bony prominence of the fifth metatarsal bone at the base of the little toe. Tailor’s bunions are not as common as bunions, which occur on the inside of the foot at the base of the first toe, but they are similar in symptoms and causes.

A bony prominence can develop on the outside of your fifth toe as a result of pressure and friction when the foot moves in the shoe. The major complaint from tailor’s bunion can range from vague and mild discomfort to severe debilitating pain in and around the small bones and joint of the little toe. Patients often describe the pain as throbbing, cramping, or piercing.

Signs and Symptoms of Tailor’s Bunions

The symptoms of tailor’s bunions include redness, swelling, numbness and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation. Callus or corn formation can also occur at the location of the the Tailor’s bunion and in some cases inward rotation of the little toe can occur.

Causes of Tailor’s Bunions

Tailor’s bunion are often thought to be genetically passed down. However, it is the foot type (flat feet or high arch feet) that is prone to developing Tailor’s bunions that is passed down, not the Tailor’s bunion itself. In these cases, changes occur in the foot’s bony framework, resulting in the development of a bony enlargement. The fifth metatarsal bone starts to protrude on an outward angle, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated when a shoe presses against it.

Regardless of the cause, the symptoms of a Tailor’s bunion are usually aggravated by wearing shoes that are too narrow in the toe area, producing constant rubbing and pressure.

Treatment for Tailor’s bunions

Treatment for Tailor’s bunion typically begins with conservative, non-surgical therapies. Some of the treatment options we recommend include:

  • Footwear modifications. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.
  • Padding. Bunion pads placed over the area may help reduce pain.
  • Analgesics. Your GP can help discuss the best pain medication option. This may include non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen that can help relieve the pain and inflammation.
  • Heat or Ice.  This condition may respond better to either heat or ice. Try heat prior to exercise and Ice afterwards.
  • Injection therapy. Injections techniques may be used to treat the inflamed tissue around the joint when used in conjunction with other treatment modalities.
  • Orthotic therapyCustom orthotic devices can help address the underlying causes and symptoms to reduce pain and progression of the condition.
  • Skin care. Removal of callus and corns help to reduce the pressure that causes the pain.

Surgery

In cases that are non-responsive to conservative treatment, surgical intervention may be required.