Bunions that form by the little toe are called a Tailor’s Bunion or Bunionette. This type of bunion is similar to one that forms by the big toe joint, except it forms on the joint just below the fifth toe. It is called a Tailor’s Bunion because years ago tailors would sit on the floor with their legs crossed and sew for hours. This constant pressure on the fifth toe, and the bone below it (the fifth metatarsal head) would cause an inflamed and painful bump to form that resembled bunions that formed on the big toe side of the foot.
A Tailor’s Bunion is a complex deformity that involves the following:
- A bump that develops on the outer side of the foot, in the area where the little toe and the bone it connects to (the fifth metatarsal) meet. The joint where these two bones meet is called the fifth metatarsophalangeal joint.
- The turning inward of the little toe, so that it presses against the fourth toe (the little toe is no longer straight)
Tailor’s Bunions are a progressive deformity, and if left untreated the bump will become larger, and the little toe will eventually lie over or underneath the fourth toe.
Causes:
The normal foot is made up of bones and joints that are held tightly together, in a precise relationship. In order for a Tailor’s Bunion to form, the ligaments and tendons that hold the bones and joints together must be more flexible (lax) than normal. This abnormal laxity allows the fifth metatarsal to gradually drift towards the outside of the foot, and the little toe to turn in, toward the fourth toe. The result is a prominent bump on the outside of the fifth metatarsal. If pressure is applied to this bump (like pressure from a shoe), the bump and its surrounding soft tissues enlarge, causing pain, swelling, and eventually a Tailor’s Bunion.A Tailor’s type deformity can also be a simple bump on the dorsal lateral side of the fifth metatarsal head and associated soft tissue. This type is very localised and is generally caused by shoe pressure or pressure from other outside sources.
Treatment:
Long-term treatment must be directed towards reducing abnormal pressure on the fifth metatarsal head. Re-balancing the foot, and allowing the foot to function as if it was not abnormally flexible best accomplish this. One of the best ways to accomplish this is custom-made orthotics. Our custom-made orthotics will gently control and reduce flexibility of the foot. This allows the foot to function normally. Make an appointment for a free foot assessment and a scan to determine if orthotics could help you.
The best short-term pain relievers include the following:
1. Wear wider and flatter shoes, with a rounded toe. We have a selection of various shoe styles that accommodate bunions, and are orthotic-friendly.
2. Apply skin emollients to the bunion, before putting your shoes on. This may help to reduce friction on the skin overlying the bunion, which may help to reduce your pain.
3. Gentle massage with a topical pain reliever can help to provide comfort.
4. Exercise the little toe. With your hand, move the toe up and down, and gently move it out as far as is comfortable, for 3 to 5 minutes daily.