Foot problem

Tailor’s Bunion

What is a Tailor’s Bunion or Bunionette?

A bunionette is similar to a bunion but smaller, and on the opposite side of the foot. It affects the joint just before the smallest toe, named the 5th metatarsophalangeal joint. Over time, a bump of bone gradually develops to the side of this joint and can become painful. As the size increases it becomes more difficult to find comfortable footwear, and symptoms of pain develop. A bunionette is often called a Tailor’s bunion because they were frequently seen in tailors who used to sit cross-legged while working.

What causes a bunionette?

Similarly to a bunion, there are no single definitive causes but, some people are genetically predisposed to developing them. We also know that repetitive trauma to a bone stimulates extra bone growth which increases its size.

What are bunionette symptoms?

Typical symptoms involve pain in this joint exacerbated from activity. Finding footwear wide enough to accommodate the bump can be a problem as pressure from shoes can be painful.

Bunionette pain on the bottom of the foot

A bunionette can be painful under and to the side of the 5th metatarsophalangeal joint. As the bump increases in size, pressure to the area increases which can also cause callus and corn formation.

Bunionette treatment

Conservative treatments include footwear changes, corn and callus removal, and custom foot orthoses (insoles). These insoles can be made to offload this joint which reduces pain and pressure. However, to accommodate this,there needs to be enough space in the shoes. Sometimes a pad with a cavity to place over the joint can help prevent rubbing from the shoe.

If the pain in the joint is acute, a one off therapeutic injection could be carried out to manage the pain. In a large portion of cases however, surgical options eventually need to be considered. This involves shaving the bony bump off, and often realigning the 5th metatarsal bone.

How to prevent bunionettes from getting worse

There are no guaranteed treatments to prevent them from becoming worse but you can manage them the best you can to help slow down worsening. If your feet are hypermobile (very flexible), stabilising them with custom foot orthoses (insoles) may help. These can be made to also include offloading of the joint.

Bunionette pads

Bunionette pads can be made and applied to the foot. These include a cavity for the bump to sit into and take pressure from this area. As with the insoles, there needs to be enough room in the shoe to accommodate this.

 

In a small number of cases if the chemical is not effective or this procedure is not suitable, the section of nail root can be surgically removed and closed with sutures.

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Thoughts and advice on foot health care from the Podogo team.