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Dealing With Mortons Neuroma

June 6, 2017
Overview

Morton neuromaMorton's metatarsalgia is a condition associated with a painful neuroma* on the digital nerve causing pain in the foot. Charcterised by perineural fibrosis and nerve degeneration due to repetitive irritation, is thought to be due to irritation of the digital nerve caused by repeated trauma, ischemia or entrapment of the nerve, occurs most frequently in women aged 40-50 who wear high-heeled, pointed-toe shoes. The neuroma occurs at the level of the metatarsal necks. The common digital nerve to the third/fourth metatarsal spaces is most often affected, although other interspaces can be involved.

Causes

There are a number of common causes for Morton?s Neuroma, (though the condition can arise spontaneously for reasons still unknown). The Neuroma often occurs in response to irritation, pressure or traumatic injury to one of the digital nerves leading to the toes. A thickening of nerve tissue results as part of the body?s response to the irritation or injury. Abnormal foot movement used to compensate for bunions, hammertoes, flatfeet and other conditions can lead to irritation and development of Morton?s Neuroma. Pronation of the foot may cause the heads of the metatarsal bones to rotate slightly, thereby pinching the nerve running between the metatarsal heads. Chronic pressure or pinching causes the nerve sheath to enlarge, becoming increasingly squeezed, producing worsening pain over time, if not addressed. Morton?s Neuroma can be exacerbated when tight shoes providing little room for the forefoot are worn. Activities which over-pronate the foot (such as walking barefoot in sand) may increase the pain associated with Morton?s Neuroma, as will any high-impact activity, such as jogging.

Symptoms

The most common presenting complaints include pain and dysesthesias in the forefoot and corresponding toes adjacent to the neuroma. Pain is described as sharp and burning, and it may be associated with cramping. Numbness often is observed in the toes adjacent to the neuroma and seems to occur along with episodes of pain. Pain typically is intermittent, as episodes often occur for minutes to hours at a time and have long intervals (ie, weeks to months) between a single or small group of multiple attacks. Some patients describe the sensation as "walking on a marble." Massage of the affected area offers significant relief. Narrow tight high-heeled shoes aggravate the symptoms. Night pain is reported but is rare.

Diagnosis

A doctor can usually identify Morton's neuroma during a physical exam. He or she will squeeze or press on the bottom of your foot or squeeze your toes together to see if it hurts. Your doctor may also order an X-ray of your foot to make sure nothing else is causing the pain.

Non Surgical Treatment

Pain is the main reason that you seek treatment for a neuroma. Analgesics may help. Inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures. Anti-inflammatory medications may help. Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and orthotics to offload the irritated nerve. One of the biggest factors in relieving pain may be changing or modifying your footwear. This may mean adding felt, foam or gel products to your shoe to help offload the area, or looking at avoiding tight fitting heels or shoes.Morton neuroma

Surgical Treatment

Surgery for neuroma most often involves removing affected nerve in the ball of the foot. An incision is made on the top of the foot and the nerve is carefully removed. Surgeon must remove the nerve far enough back so that the nerve doesn?t continue to become impinged at the ball of the foot. Alternatitvely, another type of surgery involves releasing a tight ligament that encases the nerve. Recovery after Morton?s neuroma (neurectomy) surgery is generally quick. Typically patients are walking on the operated foot in a post-surgical shoe for 2 - 4 weeks, depending on healing. Return to shoes is 2-6 weeks after the surgery. Factors that may prolong healing are age, smoking, poor nutritional status, and some medical problems.

Do I Have Inferior Calcaneal Spur

September 29, 2015
Heel Spur

Overview

The heel bone is the largest bone in the foot and absorbs the most amount of shock and pressure. A heel spur develops as an abnormal growth of the heel bone. Calcium deposits form when the plantar fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Heel spurs can cause extreme pain in the rearfoot, especially while standing or walking.

Causes

One of the most common causes for the development of heel spurs is the wearing of shoes that are too tight. That?s why more women suffer from heel spurs more than men. Athletes who tend to stress their feet a lot, people are overweight who have more pressure on their lower extremities and the elderly also tend to suffer more from heel spurs.

Inferior Calcaneal Spur

Symptoms

Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone, becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and discomfort is felt on the bottom of the foot or heel.

Diagnosis

Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at all.

Non Surgical Treatment

The first line of treatment for Heel Spur is to avoid the activities and positions that cause the pain. A physician can evaluate your foot with an X-ray to diagnose Heel Spur and determine a course of treatment. This condition can often be treated by non-surgical means; however in severe cases surgery may be necessary to relieve the pain. The most common surgical procedures treat the soft tissues around the Heel Spur, often a tarsal tunnel release or a plantar fascia release. Injections for heel spurs are sometimes controversial as steroids may cause heel pad atrophy or damage the plantar fascia.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.

Prevention

Heel Spur symptoms can be prevented from returning by wearing proper shoes and using customized orthotics and insoles to relieve pressure. It is important to perform your exercises to help keep your foot stretched and relaxed.

How You Can Diagnose Calcaneal Spur

September 25, 2015
Heel Spur

Overview

It shouldn't hurt to get to your feet in the morning or walk throughout your day, but if your steps result in stabbing or aching pain in one or both heels, you may be suffering from heel spurs. Also known as calcaneal spurs or osteophytes, heel spurs are pointed, hooked or shelf-shaped calcium build-ups on the heel bone (calcaneus). While the spurs, themselves, do not sense pain, their tendency to prod the soft, fatty tissues of the heel can result in severe discomfort with every step you take. This article will teach you what you need to know about heel spurs so that you can understand your symptoms and find fast relief from your pain.

Causes

Heel Spur typically occurs in people who have a history of foot pain, and is most often seen in middle-aged men and women. The bony growth itself is not what causes the pain associated with heel spur. The pain is typically caused by inflammation and irritation of the surrounding tissues. Approximately 50% of patients with a heel spur also experience Plantar Fasciitis.

Inferior Calcaneal Spur

Symptoms

Heel spurs are most noticeable in the morning when stepping out of bed. It can be described as sharp isolated pain directly below the heel. If left untreated heel spurs can grow and become problematic long-term.

Diagnosis

The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.

Non Surgical Treatment

Treatment of heel spurs is the same as treatment of plantar fasciitis. Because these problems are related, the treatment is the same. The first step in the treatment of a heel spur is short-term rest and inflammation control. Here are the steps patients should take in order to cure the symptoms of plantar fasciitis and heel spurs. Avoiding the activity that caused the symptoms is the first step in treatment. For example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down. Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after a sudden flare up of symptoms. Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly. Many patients will work with a physical therapist, or you can try some simple activities on your own. If you need some help, meet with a therapist for a few sessions to learn a program you can continue on your own.

Surgical Treatment

Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.

Will A Posterior Calcaneal Spur Cause Pain?

September 25, 2015
Heel Spur

Overview

Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.

Causes

When the Plantar Fascia is allowed to rest during sleep or long periods of inactivity, the fascia tightens and shortens. When you first stand up after resting, the fascia is forced to stretch very quickly causing micro-tears in the tissue. This is why the first steps in the morning are so exquisitely painful. Heel spurs are more likely to happen if you suffer from over-pronation (walking with a rolling gait) you stand or walk on rigid surfaces for long periods, you are above ideal weight or during pregnancy, you have stiff muscles in your calves.

Calcaneal Spur

Symptoms

The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.

Diagnosis

Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.

Non Surgical Treatment

Rest your foot. Reduce the amount of weight-bearing activities you participate in. Get off of your feet and elevate them. This will allow healing to begin. Apply ice to your foot. Applications of ice packs that provide a comfortable cooling to the heel and arch (not a freezing cold) will help reduce pain, swelling, and inflammation. Apply the ice to the heel and arch (not the toes). Make sure it is comfortable, and leave on your foot for about 20 minutes, 3 times a day. If you have any medical problems such as diabetes, poor circulation, etc., discuss the use of ice with your doctor before applying the ice. Active Wrap allows you to apply comfortable cold therapy to your foot without messy ice cubes. Use while on the ?go.? Do not walk with bare feet. Always protect your heels, arches, and plantar fascia with good supportive shoes. Vionic Orthotic Flip Flops For Men and Women are designed for walking comfort with built in orthotic foot beds that help reduce foot pain from heel spurs. Use in the house or on the beach.

Surgical Treatment

In some cases, heel spurs are removed by surgery after an X-ray. While the surgery is typically effective, it?s a timely and expensive procedure. Even after surgery, heel spurs can re-form if the patient continues the lifestyle that led to the problem. These reasons are why most people who develop painful heel spurs begin looking for natural remedies for joint and bone pain. Surgery isn?t required to cure a heel spur. In fact, more than 90 percent of people get better with nonsurgical treatments. If nonsurgical methods fail to treat symptoms of heel spurs after 12 months, surgery may be necessary to alleviate pain and restore mobility.

Bursitis On The Foot

August 28, 2015
Overview

In the ankle, 2 bursae are found at the level of insertion of the Achilles tendon. The superficial one is located between the skin and the tendon, and the deep one is located between the calcaneus and the tendon. The latter is the one more commonly affected by bursitis.

Causes

The most common causative organism is Staphylococcus aureus (80% of cases), followed by streptococci. However, many other organisms have been implicated in septic bursitis, including mycobacteria (both tuberculous and nontuberculous strains), fungi (Candida), and algae (Prototheca wickerhamii). Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia, alcoholism, skin disease, and trauma. A history of noninfectious inflammation of the bursa also increases the risk of septic bursitis.

Symptoms

Achiness or stiffness in the affected joint. Worse pain when you press on or move the joint. A joint that looks red and swollen (especially when the bursae in the knee or elbow are affected). A joint that feels warm to the touch, compared to the unaffected joint, which could be a sign that you have an infection in the bursa. A ?squishy? feeling when you touch the affected part. Symptoms that rapidly reappear after an injury or sharp blow to the affected area.

Diagnosis

Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area. If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.

Non Surgical Treatment

According to the National Institutes of Health, custom heel wedges can be purchased by people suffering from retrocalcaneal bursitis. These wedges reduce stress on the heel, which can reduce the pain and inflammation associated with an inflamed bursa. They can be purchased without a prescription, making it easy for anyone experiencing a flare-up of symptoms to get the added support of these wedges.

Surgical Treatment

Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).

Bursa Foot Indicators

August 23, 2015
Overview

Calcaneal bursitis is seen somewhat frequently, particularly if the clinician has a predominantly musculoskeletal practice. No mortality is associated with calcaneal bursitis. Morbidity is associated with progressive pain and limping (antalgic gait) in patients who have not received adequate treatment. If chronic inflammation also affects the distal Achilles tendon, rupture of the tendon may occur. No race predilection has been documented. Calcaneal bursitis is observed in men and women. However, some increased risk may be incurred by women who wear high-heeled shoes. Calcaneal bursitis is commonly observed in middle-aged and elderly persons, the condition is also seen in athletes of all ages.Bursitis is a painful swelling of a small sac of fluid called a bursa. Bursae (plural of bursa) cushion and lubricate areas where tendons, ligaments, skin, muscles, or bones rub against each other. People who repeat the same movement over and over or who put continued pressure on a joint in their jobs, sports, or daily activities have a greater chance of getting bursitis.

Causes

Inflammation of the bursa causes synovial cells to multiply and thereby increases collagen formation and fluid production. A more permeable capillary membrane allows entrance of high protein fluid. The bursal lining may be replaced by granulation tissue followed by fibrous tissue. The bursa becomes filled with fluid, which is often rich in fibrin, and the fluid can become hemorrhagic. One study suggests that this process may be mediated by cytokines, metalloproteases, and cyclooxygenases.

Symptoms

The signs and symptoms of heel bursitis can include heel pain wearing particular footwear, Pain or discomfort in the heel when walking, jogging or running, Swelling or inflammation in the heel.

Diagnosis

Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels test. Glucose levels that are significantly lower than normal may indicate infection.

Non Surgical Treatment

During the initial acute phase of the condition, patients should apply ice to the back of the heel for 15 to 20 minutes and follow the R.I.C.E.R regime. Avoid activities that cause pain. Gradual progressive stretching of the calf muscle and Achilles tendon is also advocated. Changing the footwear. Wearing an open-backed shoe may help relieve pressure on the affected region. For those whose symptoms were caused by a sudden change from wearing high-heeled shoes to flat shoes, the temporary use of footwear with a heel height in between may be helpful. Inserting a heel cup in the shoe may help to raise the inflamed region slightly above the shoe?s restricting heel counter and relieve the pain. It is advisable to also insert the heel cup into the other shoe to avoid any leg-leg discrepancies that can lead to other problems. Training frequency and intensity should be gradually progressed with adequate rest between trainings.

Surgical Treatment

Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.

Prevention

Maintain proper form when exercising, good flexibility, and strength around the ankle to help prevent this condition from arising. Proper stretching of the achilles tendon helps prevent injury.

Coping With Bunion And Hammertoe Surgery

June 27, 2015
Hammer ToeOverview

A Hammer toes or contracted toe is a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe is a similar condition affecting the distal interphalangeal joint. Claw toe is another similar condition, with dorsiflexion of the proximal phalanx on the lesser metatarsophalangeal joint, combined with flexion of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third, fourth, or fifth toes.

Causes

While most cases of hammertoes are caused by an underlying muscle imbalance, it may develop as a result of several different causes, including arthritis, a hereditary condition, an injury, or ill-fitting shoes. In some cases, patients develop hammertoes after wearing shoes or stockings that are too tight for long periods of time. These patients usually develop hammertoes in both feet.

Hammer ToeSymptoms

A hammertoe causes you discomfort when you walk. It can also cause you pain when trying to stretch or move the affected toe or those around it. Hammertoe symptoms may be mild or severe. Mild Symptoms, a toe that is bent downward, corns or calluses. Severe Symptoms, difficulty walking, the inability to flex your foot or wiggle your toes, claw-like toes. See your doctor or podiatrist right away if you develop any of these symptoms.

Diagnosis

Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of Hammer toes your range of motion. He or she may order x-rays in order to better define your deformity.

Non Surgical Treatment

To keep your hammertoes more comfortable, start by replacing your tight, narrow, pointy shoes with those that have plenty of room in the toes. Skip the high heels in favor of low-heeled shoes to take the pressure off your toes. You should have at least one-half inch between your longest toe and the tip of your shoe. If you don't want to go out and buy new shoes, see if your local shoe repair shop can stretch your shoes to make the toe area more accommodating to your hammertoe.

Surgical Treatment

Surgery may be the treatment of choice if conservative approaches prove unsuccessful. Usually performed as an outpatient procedure, the specific surgery will depend on the type and extent of injury to the toe. Recovery my take several days or weeks and you may experience some redness, stiffness and swelling of the affected toe. Your physician will recommend taking it easy and to keep your foot elevated while you recover.

HammertoePrevention

Prevention of a hammer toe can be difficult as symptoms do not usually start until the problem is well established. Wearing shoes that have extra room in the toes may help the problem or slow down its development.

New Hammertoe Surgery

June 27, 2015
HammertoeOverview

A hammertoe is a toe that is bent because of a weakened muscle. The weakened muscle makes the tendons (tissues that connect muscles to bone) shorter, causing the toes to curl under the feet. Hammertoes can run in families. They can also be caused by shoes that are too short. Hammertoes can cause problems with walking and can lead to other foot problems, such as blisters, calluses, and sores. Splinting and corrective footwear can help in treating hammertoes. In severe cases, surgery to straighten the toe may be necessary.

Causes

Wearing shoes hammertoe that squeeze the toes or high heels that jam the toes into the front of the shoe. Other causes or factors in the development of hammertoes can include an injury such as badly stubbing your toe, arthritis and nerve and muscle damage from diseases such as diabetes. And, hammertoes tend to run in families, although it is more likely the faulty foot mechanics that lead to hammertoes that are inherited, not the hammertoes themselves. Hammertoe generally affect the smaller toes of the foot, especially the second toe, which for many people is the longest toe. It's uncommon for the big toe to be bent this way.

HammertoeSymptoms

The symptoms of a hammer toe include the following. Pain at the top of the bent toe upon pressure from footwear. Formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.

Diagnosis

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.

Non Surgical Treatment

If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.

Surgical Treatment

Surgery to correct for a hammertoe may be performed as a day procedure. There are several different types of procedures that can be used depending on the foot structure and if the deformity is flexible or rigid.

HammertoePrevention

In addition to wearing proper shoes and socks, walking often and properly can prevent foot injury and pain. The head should be erect, the back straight, and the arms relaxed and swinging freely at the side. Step out on the heel, move forward with the weight on the outside of the foot, and complete the step by pushing off the big toe. Exercises specifically for the toe and feet are easy to perform and help strengthen them and keep them flexible. Helpful exercises include the following. Raise and curl the toes 10 times, holding each position for a count of five. Put a rubber band around both big toes and pull the feet away from each other. Count to five. Repeat 10 times. Pick up a towel with the toes. Repeat five times. Pump the foot up and down to stretch the calf and shin muscles. Perform for 2 or 3 minutes.

Hammer Toe Surgery Treatment

June 26, 2015
HammertoeOverview

The 2nd toe is the most common digit to develop a hammertoe deformity. Second toe hammer toes commonly result from an elongated 2nd metatarsal and from pressure due to an excessively abducted great toe (hallux valgus deformity) causing a bunion. Unusually long toes often develop hammer toe deformities. Painful corns often develop in hammer toe deformity, particularly of the 5th toe. Reactive adventitial bursas often develop beneath corns, which may become inflamed.

Causes

Hammertoes are most common in women, and a big part of this is poor shoe choices, which are a big factor in the development of many foot problems. Tight toe boxes and high heels are the biggest culprits. Genetics certainly plays a role in some cases of hammertoes, as does trauma, infection, arthritis, and certain neurological and muscle disorders. But most cases of contracted toes are associated with various biomechanical abnormalities in how a patient walks. This causes the muscles and tendons to be used excessively or improperly, which deforms the toes over time.

Hammer ToeSymptoms

Symptoms of a hammertoe are usually first noticed as a corn on the top of the toe or at the tip which produces pain with walking or wearing tight shoes. Most people feel a corn is due to a skin problem on their toes, which in fact, it is protecting the underlying bone deformity. A corn on the toe is sometimes referred to as a heloma dura or heloma durum, meaning hard corn. This is most common at the level of the affected joint due to continuous friction of the deformity against your shoes.

Diagnosis

A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.

Non Surgical Treatment

A toe doctor can provide you with devices such as hammer toe regulators or straighteners. These are also available for purchase locally. Another good idea is to start the hammer toe rehabilitation process by gently trying to straighten the joint and moving and flexing the affected toe as much as possible without straining it. If hammer toe taping doesn?t work, you may Hammer toes require surgery. If the joints and tendons have stiffened to a point of non-movement, hammer toe corrective surgery may need to enter the toe and either cut or manually move some of the tendons and ligaments. Although the treatment is relatively safe fast, you may deal with some stiffness afterwards.

Surgical Treatment

In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed. Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

HammertoePrevention

Hammertoe can usually be prevented by wearing shoes that fit properly and give the toes plenty of room. Don?t wear shoes with pointed or narrow toes. Don?t wear shoes that are too tight or short. Don?t wear high-heeled shoes, which can force the toes forward. Choose shoes with wide or boxy toes. Choose shoes that are a half-inch longer than your longest toe. If shoes hurt, don?t wear them.

Rigid Hammertoes Treatments

June 26, 2015
HammertoeOverview

A Hammer toes occurs when the middle of the toe points upwards abnormally. This most often occurs in the second toe, and is often the result of a big toe bunion pushing on the second toe. A painful callous often forms on top of the first joint in the toe. Treatment of a hammer toe may consist of simple padding of the callous on top of the toe, as well as buying appropriate footwear. The best shoes for patients with a hammer toe will have a wide toebox, no pressure on the end of the toe, and will not press on a bunion (which may cause worsening of the hammer toe).

Causes

Footwear is actually the leading cause of this type of toe deformity so much so that people sometimes require hammer toe surgery to undo some of the damage. The most common problem is wearing shoes that are too short, too narrow or too tight. These shoes constricts the feet and force the toes into a bend position. Women are more at risk especially due to high heels. Footwear isn?t the only problem, poor foot posture can lead to muscle and even bone imbalances. This asymmetry can cause excessive strain on the toes either by forcing the toe into unnatural positions. Arthritis can also play a factor hammertoe in the development of hammer toe, especially if the toe joint is stiff and incapable of a full range of motion.

HammertoeSymptoms

The symptoms of hammertoe are progressive, meaning that they get worse over time. Hammertoe causes the middle joint on the second, third, fourth, or fifth toes to bend. The affected toe may be painful or irritated, especially when you wear shoes. Areas of thickened skin (corns) may develop between, on top of, or at the end of your toes. Thickened skin (calluses) may also appear on the bottom of your toe or the ball of your foot. It may be difficult to find a pair of shoes that is comfortable to wear.

Diagnosis

Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.

Non Surgical Treatment

There are many non-surgical treatments to help relieve symptoms of hammertoe. The first step for many people is wearing the right size and type of shoe. Low-heeled shoes with a boxy or roomy toe area are helpful. Cushioned insoles, customized orthopedic inserts, and pads can provided relief as well. Splints or straps may be used to help correct toe position. Your doctor may show you toe stretches and exercises to perform. Your doctor can safely remove corns and calluses. You should not try to remove them at home.

Surgical Treatment

If conservative treatments don't help, your doctor may recommend surgery to release the tendon that's preventing your toe from lying flat. In some cases, your doctor might also remove some pieces of bone to straighten your toe.

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