Causes and Treatment for Tailor's Bunions, known as Bunionettes

Dr. Wishnie, a podiatrist in Piscataway and Hillsborough, NJ explains what a Tailor's Bunion (commonly known as a bunionette) is and what causes them. The most common cause of bunionettes is genetics. Shoes will irritate the problem and may make it worse. A bunionette is located on the outside of the foot near the pinky toe while a bunion is located on the inside near the big toe. The treatment for Tailor's Bunions includes injections, orthotics and possible surgery.

Bunionettes? You Ain’t Seen Nothing Yet!

Do you have a bump on the outside of your foot under the pinky toe?  Well, you could be suffering from a tailor’s bunions or what is also known as a bunionette, a mini-bunion.  It’s cousin, the main bunion, is on the opposite side of your foot under the big toe.  This is the same thing, but on the outside of the foot. Every time I hear the term bunionette I think of the group, Ronnie and the Ronettes, instead maybe we can form a new band called Paul Bunyon and the Bunionettes.  Sorry about that, I just couldn’t help myself.

So why do we call it a tailor’s bunion? Well, the real old sewing machines were not electric.  You probably don’t remember this, and I only know about this because my grandmother had one, these old sewing machines ran on pedal power.  That is, you had to use your foot to make the machine work. The old tailors would use the outside of the foot to push the pedal.  I don’t know if this cause the bunion or not, but I guess a lot of tailors back then had tailor’s bunions. 

What really happens is that the fifth metatarsal deviates outward.  The bump that you feel is the bone pushing against the skin.  In addition, there is a nerve between the bone and the skin, so the bone is now irritating both of these structures.  Ouch! On top of that, your foot is now wider and you have to get your foot into a shoe, which increases the irritation.  If you get a wider shoe, your heel might slip out.

You might wonder how you got this bunionette. Bunionettes are not normally caused by tight shoes, they just irritate them.  Most foot problems are due to poor foot mechanics.  The foot is not functioning properly during gait.  Thus, the bones get out of alignment and all of this is due to poor genetics. 

What to do? There are all grades of bunionettes, simple, moderate or complexed.  Most simple bunionettes just might need some temporary padding and an injection of cortisone to stop the irritation.  To prevent it from getting worse, you might need to change the type of shoes you are wearing or change the size.  About 80 percent of the population is wearing the wrong size shoe.  If the shoe fits the front of the foot, but your heel tends to slip out, then you can get a tongue pad from the shoe store.  This will force your heel back.  I wear a size B width shoe, so all my loafers have these pads. 

Besides padding, injections or changing your shoes, you might need a custom orthotic, which is an insert that is made especially for you to keep the foot aligned and prevent the bunionette from worsening.
In more severe cases, where the bunionette is bigger, surgery will most likely be necessary.  This is a same day procedure and you can go home walking with a walking boot.  Crutches or a cast is rarely necessary.  If your job is most of a sitting one, then you might just miss a day or two.  You will be back into your regular walking shoes in approximately four weeks.  Most patients state they have minimal pain.  The key is to ice the area as much as possible during the first three days after the procedure. 

So, if you have a bunionette, and even if it is not painful, go see your podiatrist, before it gets larger.  This way, surgery maybe prevented.