What is a tailor's bunion and how can it be treated?
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Whilst not as common a location for a bunion, bunions can occur on the outside of the foot and are known as a tailor’s bunion. Also known as a bunionette, they are smaller, however no less painful for sufferers.
The tailor’s bunion is so called due to them being highly prevalent in the clothing industry in days of yore, when tailors used to sit on the floor in a cross-legged position day in day out. The pressure placed on the outside of the fifth metatarsal joint of the small toe resulted in a permanent deformity and the formation of a bunion.
In recent years, as with bunions on the inside of the foot, the cause is from wearing badly fitting shoes in most cases. Any shoe which overly cramps the toes and places pressure on the joints puts the feet at risk of developing a bunion. Many people choose to wear shoes which are too small, or have never had a proper shoe fitting and do not know their proper size. These can all contribute to the condition, and footwear should always be changed to more bunion friendly shoes.
Tailor’s bunions are particularly common with people who have wide feet, due to the additional pressure placed on the outside of the foot, and the tightness of many standard shoes.
Associated medical problems
A tailor’s bunion is often accompanied by metatarsalgia, which is pain in the ball of the foot at the head of the metatarsals and the first interphalangeal joint. Intractable Plantar Keratosis (IPK) can also occur under the heads of these bones, which sees the formation of calluses as the weight distribution is changed. The area can become inflamed and skin lesions develop on the outside of the foot at the point of the interphalangeal joint.
Tailors bunion treatment
A tailor’s bunion can be easily cured although a medical diagnosis and an x-ray is often required in the first case to reveal the extent of the problem. It is quite normal that a visual diagnosis alone will be sufficient to diagnose, as due to the location they tend to be quite pronounced, even early on in the formation process.
Sometimes a lump in the characteristic position can just be a bone defect or bone spur. Generally the bunion will be accompanied by inflammation and soreness of the skin. Due to the bunion protruding it offers a point of abrasion and sores and blisters can form from the continual rubbing of the area against the upper of the shoe.
Surgery is a rarity as corrective measures can be easily taken to restore the toe to the correct position. Changing to a shoe with a wide toe box will usually be sufficient treatment in itself and there are excellent bunion shoes available such as Crocs shoes. However if there is accompanying pain or inflammation a doctor may prescribe a short course of pain medication and anti-inflammatory drugs.
Simple measures such as applying an icepack can help to keep the inflammation down and numb the pain although an over the counter anti-inflammatory painkiller such as Ibuprofen or aspirin may be required in addition. Consult a pharmacist for the best treatment and the correct dosage.
The combination of bunion pads and cushioning in the shoe will prevent pressure from being placed on the affected area to allow natural healing. An orthotic sole is highly beneficial to help support the feet and to keep them aligned correctly and to make minor corrections to the gait. In many cases treatment with corticosteroids is highly effective. This involves them being injected directly into the foot at the site of the problem.
In the most severe cases, where pain is intense and there has not been a significant response to other measures, a bunionectomy is considered. This is the surgical procedure performed to realign the toe and joint.
Bunion Surgery
If the condition has been present for some time bunion surgery may be required. The procedure may require deconstruction of part of the joint to allow a normal placement of the toe to be achieved. Whilst bunion laser surgery is sometimes available, it is still in its infancy. As advanced as laser technology is, it is not the best for the removal of bone. However for the small bones of the foot, where precision is required, there are currently some advances in this treatment and it is particularly effective on callused areas. Usually the surgical process involves the mechanical removal of bone through arthroplasty.
Whilst a relatively minor operation, it is not often considered worth the associated risk as the tailor’s bunion is quite often diagnosed early, and the surgery can sometimes be completed simply under local anaesthetic.
