April is National Foot Health Awareness Month!
by Dr. Hannah Johnk, Podiatrist at Myrtue Medical Center
What exactly are bunions and hammertoes?
Contrary to popular belief, it is not just a growth of extra bone. It is actually a dislocation of the joint behind the big toe. The bone behind the big toe, called the 1st metatarsal, moves and pushes the big toe toward the 2nd toe. This causes the 1st metatarsal to become prominent at the inside of the foot, creating the bump. This can make finding comfortable shoes very difficult because shoe pressure in this area causes pain. The joint dislocation can lead to arthritis, which can be painful even when walking barefoot. You can also have pain in the 1st and 2nd toes due to rubbing.
The lesser toes are all those except the big toes. If you’ve noticed that your lesser toes aren’t sitting straight, you likely have hammertoes. There are many joints, ligaments, muscles, and tendons associated with toes that make them function properly. A hammertoe results from an imbalance of these structures. There are two joints in each of the lesser toes, and one or both of them can be contracted. The entire toe can also be contracted at the joint behind the toe. These contractures cause the toe to curl, sit up higher than the other toes, and overlap neighboring toes. This can result in painful corns and calluses, as well as joint pain. Hammertoes can affect just one of your toes or all of the toes. They often go hand in hand with bunions, but not always.
What causes bunions and hammertoes?
The main cause of bunions and hammertoes is simply genetics; you were born with a predisposition to develop them. Injury and ill-fitting shoes are far less likely causes. Both issues tend to worsen slowly over time. If your bunions and/or hammertoes don’t bother you, then no specific treatment is necessary. I would recommend you exercise caution when choosing shoes as ill-fitting shoes can cause issues to develop. If your bunions and/or hammertoes do bother you, rest assured there are many treatment options to relieve pain.
What treatment options are available?
The initial treatment involves wearing properly fitting shoes. The toe box of your shoes needs to be wide and deep enough to accommodate the toes. Narrow and shallow shoes will put pressure on the toes and cause pain. Also consider the material of your shoes; leather is less forgiving than mesh or cloth and can put more pressure on the toes. Even with properly fitted shoes, you may still notice your toes rub together. There are various types of padding that can help with this, decreasing friction between toes and pressure from shoes. The pads can be foam, cotton, or silicone. You can purchase these at many pharmacies or online. I also dispense many from my clinic. You may also benefit from orthotics, which can cushion and offload the front of the foot, and if appropriate, I can dispense these from my clinic.
If these conservative measures are not successful at relieving pain, then surgery may be necessary. There are many horror stories surrounding bunion and hammertoe surgery; however, these surgeries have advanced significantly within the last decade. The procedures I perform to correct bunions and hammertoes produce consistently successful results. Sometimes crutches are necessary for about 5 weeks after surgery, but many times you can walk the day of surgery. While there is some pain during the first few weeks, it is manageable with medication.
You don’t have to live with foot pain. If you’ve had enough, make an appointment with me at Myrtue Medical Clinic. I will perform a complete evaluation and determine the best treatment course with you.
Call 833.662.2273 or 712.755.4516 to schedule an appointment today!