Tailor's-Bunion

A bunionette is an abnormal bump on the outside base of your little (fifth) toe. Commonly called tailor’s bunion, because centuries ago, tailors would get a painful bump at the base of the little toe due to rubbing the outer edge of feet on the ground as they sat cross-legged all day.

Symptoms

Redness, swelling and pain at site of bump

Difficulty wearing shoe on affected foot

Bump starts out small and painless, but becomes larger and painful over time

Small toe curved and turned towards other toes

Causes

Inherited faulty mechanical structure of foot

Progressive change of small toe as it angles towards other toes

Bony spur (outgrowth of bone) on side of fifth metatarsal (toe bone)

Narrow, tight-fitting shoes

Treatments

Treatment is focused on reducing inflammation and pain by taking pressure off the affected small toe. Surgical correction may be required if conservative therapy is ineffective.

Over the counter pain medication, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), as needed

Ice to affected area

Shoes with additional room in the toe area

Avoid shoes with pointed toes or high heels

Padding to relieve pressure

Cortisone injection

Custom orthotic device

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The tailor’s bunion is a symptomatic prominence of the fifth metatarsal bone on the outside portion of the foot. It is characterized by progressive angulation of the fifth metatarsal head and deviation of the small toe toward the other toes. Pain and occasional swelling with redness to the fifth metatarsal head at the fifth metatarsal phalangeal joint is often times seen.
The cause of the tailor’s bunion can be related to faulty biomechanics and the progressive change of the fifth metatarsal with an increase angulation of the bone that occurs slowly overtime. The tailor’s bunion is the counter part and less common to the “bunion” or hallux abducto valgus deformity. The name “tailor’s bunion” originated from tailors sitting in a cross legged fashion and excessive pressure occurring on the outside of the foot at the fifth metatarsal head.
Conservative treatment of the tailor’s bunion is supportive in nature and is focused on reducing inflammation with the temporary use of ice therapy and antiinflammtory medications like ibuprofen as well as the reduction of pressure in the region with the use of pads to take pressure off of the metatarsal head as well as wider toe box shoes.
The most important single treatment is wearing shoes that provide additional room on the toe box. Lace or buckle closure shoes tend to afford a greater amount of toe box room. Casual or athletic shoes best fit the description of shoes that provide adequate room. Dress style shoes including heels, flats and loafers tend to increase pressure in the area.

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