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Tailors Bunion

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What is a tailor's bunion?
Signs and symptoms
Causes
Diagnosis
Podiatrist treatment
Bunion surgery
Treatment process
Prevention
FAQs

While regular bunions on the big toe are a common concern for many, it is also possible to develop smaller, yet just as potentially problematic, bunions on the outside of the little (fifth) toes called tailor’s bunions or bunionettes.

What Is A Tailor's Bunion?

A tailor’s bunion is a small, bony protrusion on the outside edge of the ball of the foot - the opposite side as a regular bunion. Much like a regular bunion, the fifth toe may shift angles to face in towards the other toes. The name tailor’s bunion was coined because historically, tailors would sit cross-legged on the floor when working, which would constantly press and rub the outsides of their feet against their shoes and the ground, leading to the development of these bumps.

What Are The Signs And Symptoms Of A Tailor's Bunion?

Alongside the bony protrusion on the outside of the foot, those with tailor’s bunions may experience:

• Pain when the bunion rubs against the sides of the shoes
  
• Blisters, corns, callus or redness present on the outside of the tailor’s bunion
  
• Inflammation at the bunion
  
• Altered alignment of the fifth metatarsophalangeal joint (the point where the long bone of the foot connects with the fifth toe at the ball of the foot), leaving the joint facing outwards and the toes facing inwards
  
• Altered balance due to compromising the integrity and function of the joints at the ball of the foot 
  

As tailor’s bunions can progressively worsen over time if the right care isn’t taken, you may notice your symptoms growing more pronounced over time, with even greater structural and alignment changes at your forefoot. As such, it’s important to manage bunions early, where possible, to help prevent them from worsening or at least slow the rate of their progression so you can maintain your comfort and quality of life.

What Causes A Tailor's Bunion?

Tailor’s bunions are often the result of weakness, problems or issues with your foot biomechanics or the mechanical structure of your feet, which then leads to instability of the joints or overloading on the outside of your foot. On top of this, tailor’s bunions are further aggravated by:

• Pressure or friction (rubbing) against the fifth toe joint on the outside of the foot
  
• Regularly wearing tight or narrow shoes that press or rub against the outside of the foot
  
• Regularly sitting cross-legged – For example, a Pilates or yoga instructor, or how tailors used to
  
• Muscle imbalances, including calf muscle tightness
  
• Arthritic changes to the joints
  
• Injury to the foot
  
• Hypermobility or loose ligaments
  

In many cases, weakness and instability of the feet is linked to inherited (genetic) factors.

How Is A Tailor's Bunion Diagnosed?

As the bony protrusion at the fifth metatarsophalangeal joint is quite pronounced, your podiatrist can confidently diagnose your tailor’s bunion based on a visual examination of the foot, any symptoms (like redness of the outside of the joint) as well as learning about your lifestyle factors (such as the tendency to sit cross-legged).

If we want to know more specific information about whether any damage has occurred within the joint, we can also refer you for x-ray imaging.

How Can A Podiatrist Help Treat A Tailor's Bunion?

Treating a tailor’s bunion is done according to the level of flexibility available at the joint. For some, their tailor’s bunion will be rigid and fixed in place, in which case the goal of the treatment is to help offload pressure away from the joint, treat any symptoms like corns that have developed on the side of the bunion, help prevent it from worsening, and keep you as comfortable as possible while you walk.

For bunions that are still flexible and in their early stages, it may be possible to try to support a better joint alignment while also preventing the tailor’s bunion from worsening, or at least slowing it’s progress. In this case, we may use:

• Foot mobilisation therapy to help free up any joints and restrictions that may be contributing to overloading on the outside border of the foot and placing pressure on the little toe 
  
• Custom foot orthotics may be used to help re-distribute pressure away from the painful areas of your foot, correct biomechanical foot problems that may be playing a role in your bunion progression, and enable optimal foot function
  
• In-shoe padding or silicone products to alleviate pressure away from the tailor’s bunion (and any pressure the toe is placing on the other toes) for short-term relief
  
• Stretching and strengthening program to improve the strength, mobility and flexibility not only in the affected joint but the other foot and ankle joints and soft tissue structures.
• Splinting or taping to help improve and maintain the movement of the little toe
  
• Footwear review or modifications to ensure your shoes are not prone to rubbing against the outside of your foot and contributing to your symptoms, and instead are leaving you with sufficient forefoot width and wiggle room for your toes
  
• MLS laser for pain relief of your tailor’s bunion is causing you significant pain
  

We also remove any corns or callus that has built up around the bunion, helping reduce pain and pressure on the joint.

Tailor’s Bunion Surgery

Generally, we consider surgery for bunions as a “last resort” as the alternative non-surgical conservative options that we mentioned have proven to be successful in most cases. Surgery is an invasive procedure that carries risk, has a significant recovery time (8 weeks to 6 months), has no guaranteed results, instead putting you at risk of potential complications including nerve damage, infection, issues with bone healing, loss of movement in the little toe, pain, stiffness and more.

As such, we highly recommend trying non-surgical therapies first. If your symptoms do not improve and your tailor’s bunion is impacting your quality of life and day-to-day comfort, we can refer you for a consultation with a trusted orthopaedic surgeon.

How Does Our Tailor's Bunion Treatment Process Work?

Having your tailor’s bunion treated with our podiatry team at our Brisbane City and Newmarket clinics includes coming in for a consultation and assessment. and then having We’ll present and explain the treatment options that are suitable for you given your circumstances and the stage of your bunion,, as well as the outcomes we’d expect. After you select your preferred treatment path, we’ll get started on each of the therapies, doing what we can on the day and booking subsequent appointments as needed.  

Does Tailor's Bunion Treatment Hurt?

No, treating a tailor’s bunion is typically non-painful as it’s completely non-invasive and any hands-on manual therapies are gentle in nature.

How To Prevent A Tailor's Bunions From Growing

The best way you can try to prevent tailor’s bunions is by wearing supportive, roomy shoes that have sufficient space in the toe box, while avoiding shoes that are narrow, pointed, cause rubbing along the sides of your feet, or are high-heeled. Pay close attention to any redness or rubbing on the outside border of your feet, and if you notice this, seeing your podiatrist immediately can also help any undue pressure from turning into a bunion.

FAQS

What happens if you don't treat a tailor's bunion?

Leaving a tailor's bunion untreated, especially if it’s causing you discomfort, may result in:

• The bunion gradually worsening, meaning treatment later on will be more intensive, and the severity of your tailor’s bunion may be harder to manage in terms of pain and function.
  
• Bursitis simultaneously occurring from the bunion causing irritation to the fluid-filled sac (bursa) that cushions the joint, leading to inflammation and swelling, then pain and tenderness.
  
• Arthritis developing and eventually causing rigidity in the joint. 
  
• Your foot may become deformed due to impact on other toes and toe joints
  
• Losing movement in your little toe altogether
  
• Developing chronic pain in the area
  

Will orthotics help a tailor's bunion?

Orthotics are one treatment option that may be recommended for some people with a tailor’s bunion, if in their circumstances, their foot biomechanics is causing them to overload the little toe and outer border of the foot, leading to the joint destabilising and the bunion growing more pronounced over time.

Will a tailor's bunion go away of its own?

No, a tailor’s bunion does not go away on its own, because the factors that have led to the bunion developing in the first place are usually not changed. It’s only when the causes of a tailor’s bunion are identified and addressed can positive change occur.