A Tailor's bunion is also known as a 'mini-bunion'. The pain stems from irritation of the skin and underlying soft tissue at that area as it is being pressed between the bone below and the shoe to the outside. This bone, called the 5th metatarsal, is the long bone along the side of the foot. The top of the bone can become enlarged and prominent over time. In some people, this bone can be angled too far away from the center of the foot, causing it to stick out more instead of having a simple enlargement. Regardless of the cause, the end result is pain in one's shoes as they rub against the side of the foot. Eventually, the foot may become so tender that even walking or standing barefoot can cause discomfort. Sometimes a swollen sac of protective fluid may be present at the irritated area, which can cause even more pain if the pressure exceeds the protection of the sac (called a bursa).
Treatment simply starts with making sure you are wearing the proper sized shoe for your foot, taking into consideration any extra width needed to accommodate for the enlarged bone prominence along the side of the foot. Icing the foot for 15-20 minutes a couple times a day can also help with inflamed skin, as can anti-inflammatory medications such as ibuprofen, naproxen, and numerous prescription medications. Sometimes extra padding applied to the side of the foot is enough to relieve the pain, as long as it is not too thick as to create too much pressure in the shoe. Cortisone-like steroid injections can also be considered if the bursal sac is inflamed. If all these measures do not help relieve the pain, then the next step is to simply have the Tailor's bunion removed surgically. For most people, this simply requires a short procedure in which the enlarged or prominent bump is removed by shaving the bone, and smoothing out the end. Recovery is usually brief, with most patients returning to a regular shoe within 3-4 weeks. For those with bones that are angled too far from each other, a procedure is required that moves the bone over to the proper position. The bone is then secured with a pin or screw. Usually requiring 6 weeks in a protective boot for bone healing, this procedure fixes the underlying deformity in a permanent manner, as simply shaving the bone in these cases will not be successful in the long term.