Our Podiatrists In Miami & Hialeah Can Help With Your Bunions & Hammertoes
A bunion occurs when the joint at the base of your big toe becomes enlarged, sore and swollen. Your big toe may start to angle toward your second toe, or move underneath it. Women are most affected by bunions, which are often caused by wearing narrow, tight shoes, or high heels. A bunionette occurs on the other side of the foot, near your small toe, and is much smaller than a bunion.
A podiatrist can usually diagnose a bunion during a physical exam. An X-ray may provide further information about the joint, the angle of the toe, and if arthritis or gout are concerns to further investigate.
Wearing comfortable shoes with a wide toe-box at the first signs of a bunion appearing can decrease its growth and reduce any further complications. Resting the foot, using anti-inflammatory medications and icing the area may help. In some cases a cortisone shot at the base of the big toe may help. In cases when the bunion is causing severe pain, surgery may be performed to remove the bony bump and to realign the toe.
Ignoring a bunion will lead to increased pain and the chance of contracting bursitis, when the small fluid-filled sac next to the joint becomes inflamed. Depending on how severe your bunion is, your foot can become deformed and continue to cause chronic pain.
If the joint on one of your toes - usually the toe next to the big toe or the smallest toe - points upward rather than lying flat, you might have a hammertoe. The condition is actually a deformity that happens when one of the toe muscles becomes weak and puts pressure on the toe's tendons and joints. This pressure forces the toe to become misshapen and stick up at the joint. Also, there's frequently a corn or callus on top of the deformed toe. This outgrowth can cause pain when it rubs against the shoe.
"The term, hammertoe, is commonly used as a general classification for any condition where the toe muscle weakens, causing digital contracture, and resulting in deformity," explains our very own Dr. Juliette Perez, DPM. But she adds that a digital contracture like this can actually be a hammertoe, claw toe or mallet toe, depending on which joints in the toe are contracted.
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people. Hammertoes may be aggravated by shoes that don't fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.
Hammertoes are progressive they don't go away by themselves and usually they will get worse over time. However, not all cases are alike some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
There are several treatment options that vary according to how severe the hammertoe:
- Wear good-fitting shoes; this does not necessarily mean expensive shoes. Padding any prominent areas around the bony point of the toe may help to relieve pain.
- Drugs that reduce inflammation can ease the pain and swelling. Sometimes, a doctor will use cortisone injections to relieve acute pain.
- An orthotist or qualified medical provider such as a podiatrist may also custom-make an insert to wear inside your shoe. This can reduce pain and keep the hammertoe from getting worse.
- Over-the-counter metatarsal pads that are properly placed may help.
- The doctor may recommend foot exercises to help restore muscle balance. Splinting the toe may help in the very early stages.
- When the hammertoes are not resolved with the above methods, surgery may be needed. Often this can be done in a surgery center without the need for hospitalization. There are several surgical techniques used to treat hammertoes.
- When the problem is less severe, the doctor will remove a small piece of bone at the involved joint and realign the toe joint. More severe hammertoes may mean more complicated surgery.
Pain and walking difficulty may increase, and a permanent deformity may occur. Repeated friction to the tip or the top of the toe can lead to wounds and infection.