Tailor's Bunion - Bump on the Pinkie Toe Side of the Foot

A bunion is a bump that forms on the toe joint, often causing a characteristic red, swollen bump on the top or side of the joint and resulting in a widening of the forefoot (toe area).

A bunion on the pinkie toe side is known as a bunionette, or tailor's bunion. This foot condition came to be known as a tailor's bunion from the notion that tailors often sat in a cross-legged position while they worked, putting pressure on the outside of the foot. It was thought that this chronic pressure led to the development of the characteristic bump.

These changes can cause pain, make it difficult to wear shoes due to the widened forefoot, and can create cosmetic concerns.

Symptoms of a Tailor's Bunion

A tailor's bunion progresses gradually, usually beginning with a prominence, or bump over the side of the fifth metatarsal bone. This is the area where the pinkie toe forms a joint with the long fifth metatarsal bone.

• The bump can increase in size over time, causing pain and making it difficult to find shoes that fit well.
• The chronic rubbing of the bump against the shoe can also cause the skin in that area to become red and irritated, sometimes leading to a skin callus.
• Swelling and pain in the area of the bump can also occur. These are signs of bursitis, which is an inflamed pocket of fluid.

If you have a tailor's bunion, you may also notice that your foot appears to have gotten wider. This widening occurs because of the gradual separation of the fifth metatarsal bone from the fourth metatarsal bone that lies next to it.

What Causes a Tailor's Bunion?

Abnormal foot function is a common cause of a tailor's bunion. Separation of the metatarsal bones is how a bunion forms structurally.

New activities or sports are examples of things that can cause a tailor's bunion to develop. The foot is a complex, shock-absorbing structure with many joints. If there is excess motion in one part of the foot when stability is needed, changes in foot structure can occur.

Other causes of a tailor's bunion include a hereditary, abnormal shape or position of the fifth metatarsal bone, as well as tight-fitting shoes.

Interestingly, tailor's bunions occur much more often in women than men. One reason for this is thought to be women's shoe wear—specifically, high heels and pointed-toe styles, which affect foot function.

Treatment of a Tailor's Bunion

Non-surgical care of a tailor's bunion may involve procedures to relieve pain or reduce any abnormal foot function that has been identified. An X-ray or other imaging study may help evaluate the structures around the fifth metatarsal.

Wearing wider shoes with soft material that can expand in the toe box can help relieve discomfort that's caused by a bunion and prevent complications, such as callouses. Orthotics, which are specialized arch supports, may be recommended to treat problems with foot function. Over-the-counter padding devices can also help with minimizing shoe irritation.

Pain management may involve a cortisone injection if bursitis or swelling is present. A callus may be shaved off (a procedure known as debridement) for additional pain relief.

Surgery may be an option, especially if there are abnormalities in the fifth metatarsal bone. Procedures may involve shaving the bump or repositioning the fifth metatarsal bone. These surgical procedures involve some downtime afterward but are the only effective way to correct a tailor's bunion.