What is a tailor’s bunion?
A tailor’s bunion, also known as a bunionette, is the medical term for a raised lump/bump at the base of the little toe. The bump appears due to the altered position of the little toe, instead of pointing in the same direction as the rest of the toes the little toe points across the foot towards the big toe.The mid-section of the foot consists of 5 long metatarsal bones, numbered in the sense that your big toe is 1st and your little toe is your 5th. The tailor’s bunion occurs at the head of the 5th metatarsal. The metatarsals connect at the back to the cuneiforms and cuboid bones and at the front to the proximal phalangeal - toes. The metatarsals play an important role in the biomechanics of the foot. They contribute to and support the structure of the foot arch thus affecting balance and they also act like a lever in the push off movement of the foot.
Why & when do tailor’s bunions happen?
Tailor’s bunions are very similar to bunions in presentation, symptoms and causes however tailor’s bunion are far less common than the bunions, also known as hallux valgus that affect the base of the 1st metatarsal(the big toe). The bunion adopted its name as traditionally tailors would sit crossed-legged with the outside of their foot rubbing against the floor. This constant rubbing resulted in a painful lump forming at the base of their little toe. This however is not how tailor’s bunion occurs in-fact they are most often the result of poor foot biomechanics or posture like flat feet or high arches. Altered function of the feet in these circumstances leads to increased pressure through certain parts of the foot including the little toe. Bunions tend to run in the family due to an increased likelihood of inheriting a foot type that is prone to developing the condition and not in fact that they are hereditary. Footwear is also an essential key to the development of a bunion, although it doesn’t directly cause a bunion. Any footwear that squeezes and is very tight over the toes (for instance very high and pointy high heels) contributes to the condition developing further and progressing at a faster rate.
What does a tailor’s bunion feel like?
In the early stages of a bunion symptoms will be minimal with only a slight noticeable alteration in the position of your little toe. To start with the toe will slightly lean towards the other toes and a small bump at the base of the toe will be noticeable. The progression is normally relatively slow and is over quite a few years. In the later stages the symptoms become more prominent and include allot of pain and discomfort around the bump at the base of the little toe. There will be noticeable swelling and additional redness over the joint and occasionally there will be a mild burning sensation or numbness. These symptoms will be aggravated after long periods of walking or standing and after wearing tight and narrow shoes, like high heels.
How is a tailor’s bunion diagnosed?
Your GP or podiatrist/chiropodist should be able to fully diagnose you by listening to your symptom history and thoroughly examining the little toe. Your doctor will most likely order an X-ray of the foot to determine the extent of the joint deformity and to rule out any underlying arthritic joint conditions that may complicate treatment.
What treatment options are available for a tailor’s bunion?
The treatment options for a bunion vary depending on how early the condition is diagnosed and the extent of the deformity. Bunions are progressive and don’t go away so in the early stages most doctors will recommend conservative treatment to ease pain levels and try to delay the need for surgical intervention in the future. Conservative treatment will not reverse the deformity. Treatment will include ensuring you are wearing the right kind of footwear with wide toes, avoiding those pointed high heels. Specialist padding and orthotics can minimise the discomfort and pressure over the bunion. The doctor will most likely prescribe anti-inflammatory medication and painkillers for pain relief and to reduce any swelling there is also the option of using ice packs on the area or corticosteroid injections to reduce persistent inflammation and pain.
Bunions progress and develop at different rates. Doctors will normally recommend surgical intervention in more severe, progressed cases or when conservative treatment fails. Surgery is aimed at reducing the pain levels by reducing the bump and straightening the toe alignment. You will be referred to a specialist ankle and foot orthopaedic surgeon who will recommend the type of surgery based on your health, activity level and the severity and extent of your condition. The recovery and results you see after surgery will vary, depending on the type of procedure performed.