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INTRODUCTION TO TOE PAIN

Patients often refer to all forms of toe abnormalities as a hammer toe. There are in fact four main forms of toe abnormalities, hammer toes, claw toes, mallet toes and trigger toes. A hammertoe can be best described as an abnormal contraction or "buckling" of a toe. This occurs due to a partial or complete dislocation of one of the joints that form the toe. As the toe continues to be deformed, it will press up against the shoe and may cause corns.

APPEARANCE OF TOE PAIN

• There are two joints in the lesser toes and one joint in the large toe. If the deformity occurs in the lesser toes and in the joint nearest the nail, it is called a mallet toe.
• If the deformity occurs in the lesser toes and in the joint nearest the foot, it is called a hammertoe (refer to diagram below).

The diagram above shows a hammer toe.

• If the deformity in the lesser toes involves both of the joints, then the toe is referred to as a claw toe (refer to picture below).

The above picture shows a claw toe abnormality.

• If the deformity occurs in the large toe, it is known as a trigger toe.

SYMPTOMS OF TOE PAIN

• A hammer toe may be painful, especially when irritated by a shoe.
• All four toe conditions may cause cramps in the toes, foot and leg due to the abnormal function of the tendons in the foot.
• If a mallet toe has occurred, you are likely to suffer from a corn at the end of the toe.
• A hammertoe may cause a corn on the top of the toe (refer to the picture below).

The above picture shows a hard corn on the top of a hammertoe.

• Infections and ulcers can also occur.
• In severe cases a mallet toe, trigger toe, claw toe or a hammer toe may create a downward pressure on the foot, which can result in hard skin and corns on the soles of the feet.

CAUSES OF TOE PAIN

• Inappropriate shoes.
• Flat feet can result in hammertoes; this is due to poor mechanics off the foot.
• High arched feet can also result in buckling toes.
• A major cause is in hereditary, all the toe conditions mentioned could be acquired due in hereditary factors.
• Bunions are a major cause of hammertoes.
• Claw toes are usually the result of a shoe that is too short. For many people, the second toe is actually longer than the great toe, and if shoes are sized to fit the great toe, the second (and maybe even the third toe) will have to bend to fit into the shoe. Shoes that are pointed make matters even worse. Combine pointed shoes with high heels; the foot is under similar pressure as if it was constantly being pushed downhill into a wall.
• Rheumatoid arthritis can also lead to bunions, which in turn can lead to hammer toes.

 WHAT YOU CAN DO FOR TOE PAIN

• Purchase wide fitted, low heeled shoes, running shoes are ideal.
• Make sure that stockings, tights and socks are not too constrictive.
• Non-medicated pads may relieve pressure away from corns and hard skin.
• Applying an appropriate moisturizing cream will help to keep the skin soft.
• Purchase high quality silicone products such as the the silicone toe prop to cure this condition.

Dr Foot Recommends

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 WHAT YOU SHOULD NOT DO

• Ignore the pain or toe abnormality.
• Do not carry out any bathroom surgery, such as cutting a corn with a razor blade!

WHAT THE CHIROPODIST WILL DO

• Treat any foot complaints such as corns, calluses by periodically reducing the lesion and applying appropriate pads and dressings.
• Recommend the silicone toe prop.
• If an infection is present, then anti-septic dressings, antibiotics and pads to redistribute pressure away from the lesion may be necessary.
• In the case of a mallet toe, trigger toe or claw toe. If a corn occurs at the end of the toe, a silicone or leather prop may be used to straighten the toe.
• In a hammertoe deformity, a silicone prop to redistribute pressure away from a corn may be necessary.
• The chiropodist may give footwear advice.
• In severe cases, corrective surgery may be necessary.
• The chiropodist may recommend orthosis to correct a mechanical complaint of the foot, such as 3/4 length silicone insoles.