Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery by a podiatric physician is frequently recommended to correct the problem.
Claw toe normally is caused by nerve damage from diseases like diabetes or alcoholism, which can weaken the muscles in your foot, according to the American Orthopaedic Foot and Ankle Society. Having claw toe means your toes “claw,” digging down into the soles of your shoes and creating painful calluses. Claw toe gets worse without treatment and may become a permanent deformity over time.
Common symptoms include:
- Toes bent upward from the joints at the ball of the foot.
- Toes bent downward at the middle joints toward the sole of your shoe.
- Corns on the top of the toe or under the ball of the foot.
Claw toe deformities are easier to repair when detected early, but they harden into
place over time. Splint or tape is used to hold your toes in correct position.
Many disorders can affect the joints of the toes, causing pain and preventing the foot from functioning as it should. People of all ages can have toe problems, from inherited to acquired.
Toe deformities in adults are caused mainly by an imbalance of the tendons, causing them to stretch or tighten abnormally. People with abnormally long toes, flat feet, or high arches have a greater tendency to develop toe deformities.
Arthritis is another major cause of discomfort and deformity. Toe deformities also can be aggravated by poorly-fitting footwear, or if a fractured toe heals in a poor position.
The most common digital deformities are hammertoes, claw toes, mallet toes, bone spurs, overlapping and underlapping toes, and curled toes.
Hallux Limitus (Stiff Big Toe Joint)
Hallux Limitus is a condition that results in stiffness of the big toe joint
It is normally caused by an abnormal alignment of the long bone behind the big toe joint called the first metatarsal bone. Left untreated, Hallux Limitus can cause other joint problems, calluses, and diabetic foot ulcers.
Painful bone spurs also can develop on the top of the big toe joint.
Anti-inflammatory medications, cortisone injections and/or functional orthotics are some of the common treatments for stiff big toe. Consult your physician before taking any medications.
Surgery may be prescribed if spurring around the joint becomes severe.
Hallux Rigidis (Rigid Big Toe)
When you have a stiff big toe, walking can become painful and difficult. An unmovable big toe (Hallux Rigidus) often is the most common form of arthritis in your foot, according to the American College of Foot and Ankle Surgeons.
“Wear-and-tear” injuries also can wear down the articular cartilage, causing raw bone ends to rub together. A bone spur, or overgrowth, may develop on the top of the bone. This overgrowth can prevent the toe from bending as much as it needs to when you walk.
Symptoms may include:
- Pain in the joint when you are active, especially as you push-off on the toes when you walk.
- Swelling around the joint.
- A bump, like a bunion or callus, that develops on the top of the foot.
- Stiffness in the big toe and an inability to bend it up or down.
Pain relievers and anti-inflammatory medications often help to reduce swelling and ease the pain. Consult us before taking any medication. Applying ice packs or taking contrast baths (which use alternating cold and hot water to reduce inflammation) may also help reduce inflammation and control symptoms for a short period of time.
Invest in a stiff-soled shoe with a rocker or roller bottom design and possibly even a steel shank or metal brace in the sole. This type of shoe supports the foot when you walk and reduces the amount of bend in the big toe. Bone spurs, as well as a portion of the foot bone, may be surgically removed when damage is mild or moderate. The procedure also allows the toe more room to bend.
Hallux Varus is a condition in which the big toe points away from the second toe.
It often is one complication from bunion surgery. The condition has been linked to a number of other causes, including congenital deformity, tight or short abductor hallucis tendons, trauma or injury, absence or surgical removal of the fibular sesamoid.
Treatment may focus on stretching the abductor hallucis tendon through a specific kind of stretching exercise. Other options include toe splints and surgery, in which a small incision is made on the side of the toe. The toe is then splinted in a neutral or straight position.
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Causes of hammertoe include improperly fitting shoes and muscle imbalance.
Treatment for the condition typically involves shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions or non-medicated corn pads may also relieve symptoms.
Intoeing is a condition caused by curving inward of the feet when walking or running. Young children normally outgrow this condition without special shoes.
Overlapping or Underlapping Toes
Underlapping toes usually involve the fourth and fifth toes. (A special form of underlapping toes is called congenital curly toes.)
The cause of underlapping toes is generally unknown. They may be caused by an imbalance in muscle strength of the small muscles of the foot.
If deformed toes are flexible, a simple release of the tendon in the bottom of the toe will allow for them to straighten. If the deformity is rigid, surgery may be needed to remove a small portion of the bone in the toe.
Overlapping toes are characterized by one toe lying on top of an adjacent toe. The fifth toe is the most affected. Overlapping toes may develop in the unborn fetus.
Passive stretching and adhesive taping is most commonly used to correct overlapping toes in infants, but the deformity usually recurs.
Such deformities can sometimes be surgically corrected by releasing the tendon and soft tissues about the joint at the base of the fifth toe. In some extreme cases, a pin may be surgically inserted to hold the toe in a straighten position. The pin, which exits the tip of the toe, may be left in place for up to three weeks.
Subungal Exotosis (Bone Spur Under Toenail)
A Subungual Exostosis is more commonly referred to as a bone spur under toenail. They generally are a result of some form of trauma to the toe, forming a bony irregularity or prominence. They are normally treated by surgical removal. Other small tumors called Osteochondromas and Enchondromas can also form in the bone beneath the toenail as well as in other bones in the body.