What Causes Hammer Toe Pain

Hammer ToeOverview


The smallest four toes of each foot have three bony segments connected by two joints, just as the fingers do. hammertoes is a deformity in which one or more of the small toes develops a bend at the joint between the first and second segments so that the tip of the toe turns downward, making it looks like a hammer or claw. The second toe is affected most often.


Causes


A hammer toe develops because of an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture. Heredity and trauma can also lead to the formation of a hammer toe. Arthritis is another factor, because the balance around the toe in people with arthritis is disrupted. Wearing shoes that are too tight and cause the toes to squeeze can also cause a hammer toe to form.


HammertoeSymptoms


A toe (usually the second digit, next to the big toe) bent at the middle joint and clenched into a painful, clawlike position. As the toe points downward, the middle joint may protrude upward. A toe with an end joint that curls under itself. Painful calluses or corns. Redness or a painful corn on top of the bent joint or at the tip of the affected toe, because of persistent rubbing against shoes Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes.


Diagnosis


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.


Non Surgical Treatment


If your hammertoe problem is diagnosed as flexible hammertoe, there are a number of nonsurgical treatments that may be able to straighten out your toe or toes and return them to their proper alignment. Padding and Taping. Your physician may pad the boney top-part of your hammertoe as a means of relieving pain, and may tape your toes as a way to change their position, correct the muscle imbalance and relieve the pressure that led to the hammertoe's development. Medication. Anti-inflammatory drugs such as aspirin and ibuprofen can help deal with inflammation, swelling and pain caused by your hammertoe. Cortisone injections may be prescribed for the same purpose. If your hammertoe is a consequence of arthritis, your physician may prescribe medications for that.


Surgical Treatment


Sometimes, if the deformity is severe enough or surgical modification is needed, the toe bones may be fused so that the toe does not bend. Buried wires are used to allow for the fusion to heal, and hammertoe they remain in place after healing. Your skin is closed with fine sutures, which are typically removed seven to ten days after surgery. A dressing is used to help keep your toes in their new position. Dressings should not get wet or be removed. After surgery, your doctor may prescribe pain relievers, typically for the initial four to seven days. Most people heal completely within one month of surgery, with few complications, if any. Crutches or a cane may be needed to help you keep weight off your affected foot, depending on the procedure. Occasionally, patients receive a special post-op shoe or a walking boot that is to be worn during the healing process. Most people are able to shower normally after surgery, but must protect the dressing from getting wet. Many patients are allowed to resume driving within one week after the procedure, but care needs to be taken.

Do Bunions Ever Need Surgery Treatment?


Overview
Bunions Callous
A bunion is a combination of an enlargement of the joint at the base and side of the big toe as well as the big toe being angled towards the rest of the toes (this angulation is known as Hallux Valgus). A bunion can lead to other foot deformities and problems such as a hammer toe of the second toe, corns and calluses as well as ingrown toenails. So if the pain isn't enough of a driving factor, the chance of developing these further complications should outline the importance and urgency of seeking treatment with a podiatrist.

Causes
Bunions most commonly affect women. Some studies report that bunions occur nearly 10 times more frequently in women. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed shoes, might increase the risk for bunion formation. Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. While the precise causes are not known, there also seems to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals. Other risk factors for the development of bunions include abnormal formation of the bones of the foot at birth (congenital), nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.
SymptomsBunions or hallux valgus tend to give pain predominantly from the metatarsal head on the inner border of the foot. The bunion tends to be painful mainly when in enclosed shoes and so is often more symptomatic in winter. As the front part of the foot splays and the great toe moves across towards the 2nd toe a bunion can also produce pain from the 2nd toe itself. The pain which a bunion produces on the 2nd toe is either due to direct rubbing between the great toe and the 2nd toe, a hammer toe type deformity produced due to crowding of the 2nd toe by the bunion and the 3rd toe.The hammer toe will either be painful from its top aspect where it rubs directly on shoe wear or its under surface in the area of the 2nd metatarsal head. This is made prominent and pushed to the sole of the foot by the 2nd toe rising upwards and driving the metatarsal head downwards.

Diagnosis
Your doctor can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling. After the physical exam, an X-ray of your foot can help your doctor identify the cause of the bunion and rate its severity.

Non Surgical Treatment
The initial treatment of a bunion should be non-operative. Symptoms can often be greatly improved with simple non-operative interventions. Non-operative treatment may include properly fitted shoes, Properly fitting comfort shoes with a wide non-constrictive toe box, especially one that is made out of a soft material such as leather, can be quite helpful in reducing the irritation over the prominent bunion. In some instances, it is helpful to have a shoemaker stretch the inside aspect of the shoe. Jamming a foot with a bunion into a constrictive shoe will likely lead to the development of uncomfortable symptoms. Bunion pads, Medial bunion pads may also be helpful in decreasing the symptoms associated with the bunion. These pads can be obtained at many drugstores. Essentially, they serve to lessen the irritation over the medial prominence and, thereby, decrease the associated inflammation This should be combined with comfortable non-constrictive shoes. A toe spacer placed between the great toe and the second toe can help to reduce the bunion deformity and, thereby, decrease the stretch on the medial tissue and the irritation associated with the bunion. Toe spacers can be obtained at most drug stores or online. Soft shoe inserts. Over-the-counter accommodative orthotics may also help bunion symptoms. This product is particularly helpful if bunion symptoms include pain that is under the ball of the foot. Orthotics with a slight medial longitudinal arch may be helpful for patients that have associated flatfoot deformity. These can be purchased at many sports stores, outdoors stores, or pharmacies. Bunion splints have often been used to treat the symptoms associated with hallux valgus. These splints are typically worn at night in an effort to reduce the bunion deformity. There is no evidence to suggest that these splints decrease the rate at which bunion deformities occur. There is also no evidence that clearly supports their effectiveness. However, some patients report good relief with the use of these splints.
Bunions

Surgical Treatment
Several surgical procedures are available to the podiatric physician The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain.A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint. Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatric physician.

Does Overpronation Need To Have Surgery

Overview


It is estimated that around 80% of the population suffer from excessive pronation. This condition is common in all types of people from children to the elderly and from top athletes to people with a sedentary lifestyle. The feet become misaligned and combined with poor posture roll inwards to gain ground contact, the arches become flattened producing the condition known as excessive pronation. When the feet are excessively pronated a combination of poor posture and diminished shock absorption results in some areas of the feet being subjected to excessive stress and pressure. This can lead to various conditions including knee and back problems, as well as foot problems and deformities.Over Pronation


Causes


Pronation can occur as an overuse syndrome in active runners, where a great deal of stress is placed on ligaments and tendons that support the medial column. Obesity is another predictor for pronation and deterioration of the medial ligaments and posterior tibial tendon due to excessive stress on these tissues. Acute Trauma can also lead to over-pronation when ligaments are torn or tendon is ruptured. Once again this can lead to a collapse of the medial column. Arthritic conditions involving the knee joint when the joint is in varus (inner collapse) posture, this places the center of gravity over the ankle joint rather than the foot causing undue pressure on the inner ankle.


Symptoms


Overpronation can lead to injuries and pain in the foot, ankle, knee, or hip. Overpronation puts extra stress on all the bones in the feet. The repeated stress on the knees, shins, thighs, and pelvis puts additional stress on the muscles, tendons, and ligaments of the lower leg. This can put the knee, hip, and back out of alignment, and it can become very painful.


Diagnosis


Look at the wear on your shoes and especially running trainers; if you overpronate it's likely the inside of your shoe will be worn down (or seem crushed if they're soft shoes) from the extra strain.Over Pronation


Non Surgical Treatment


One of the best forms of treatment for over pronation is wearing supportive shoes. Shoes should have ample support and cushioning, particularly through the heel and arch of the foot. Without proper shoes, there may be additional strain on the tissue in the foot, greatly contributing to or causing an occurrence of over pronation. Rarely is surgery considered to relieve the pain and damage that may have resulted from this condition. Orthotic shoe inserts are often the easiest and most effective way to correct pronation.


Prevention


Custom-made orthotics will reduce the twisting of the leg muscles as they enter the foot, by maintaining a normal alignment of the bones and joints of the foot. If the bones and joints are aligned properly, by reducing the pronation, the muscles can run straight to their attachments in the foot, without twisting to get to these bones. This action of custom-made orthotics will reduce Achilles Tendonitis shin splints; ankle, knee, hip, and lower back pain; and leg cramps. This action will also allow the leg muscles to work more efficiently, thus allowing you to walk and run with less effort.
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Melina Mlenar

Author:Melina Mlenar
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