Hammertoes

Hammertoes, as the name indicates is a deformity caused as a result of contracture or bending of the second, third, fourth or the fifth toe in the foot. As a result of this abnormal bending of the toes, the person might experience pain while using shoes due to the pressure caused to the toes. Hammertoes by and large arise due to imbalance in the muscle/tendon thereby ensuing in the bending of the toes. This deformity occurs predominantly due to structural changes in the foot. Another major reason for hammertoes is inappropriately fitting shoes; shoes that lead to crowding of the toes. Other major reasons leading to this deformity are former injuries caused to the toe and sometimes heredity. Hammertoes begin gradually, as a tiny abnormality and over time worsen. If left untreated, it can cause inflexibility to the toes and will require surgical correction. Corns are another major problem for people suffering with hammertoes and these corns can never be got rid off even with frequent trimming.

Symptoms of hammertoes

• Pain or soreness in the affected toes while wearing shoes.
  
• Development of corns due to frequent friction caused to the toe by rubbing against the shoes. Corns can occur either on top of the toe, side of the toe, ends of the toe or in between two toes.
  
• Calluses can arise either on the underneath the toe or on the ball of the foot.
  Hammertoes can be treated according to the severity of the deformity; the foot/ankle surgeon will be the best person to decide on this.
  

• Trimming of the corns and calluses: The best way to get is done is through your foot/ankle surgeon, as they know how and where exactly it needs to be trimmed. Self trimming might lead to infections.
  
• Padding corns and calluses: Again the foot/ankle surgeon is the best person to decide on the right type of pad your foot will require. Over the counter pads might contain acid that may add on to the irritation to the already existing irritation in the corns and calluses.
  
• Orthotic device: A made-to-order orthotic device when placed in the shoes can help control the imbalance in the muscle or the tendon of the foot.
  
• Injection therapy: Pain and inflammation can be kept under control by injecting corticosteroid injections.
  
• Strapping/splinting: Straps/splints as prescribed by the ankle/foot surgeon can be used to try and realign the bent toe.
  

Surgical methods: With more severe cases of hammertoes, surgery is required to correct the deformation of the foot caused.

Bone Spurs

A bony growth formed on a normal bone is termed osteophyte or bone spur. It is an extra bone. Although bone spur can be smooth, it can cause wear and tear with pain in the area when a bone rubs with other bones or soft tissues such as ligaments, tendons or nerves in the body. The most common places in the body where bone spurs occur include the spine, shoulders, hands, hips, knees and heel.

Causes of bone spurs

The body tries to repair itself by building extra bones. These are formed in response to pressure, rubbing and stress that exist over a period of time. Bone spurs can also be formed due to the aging process. Cartilage breaks down and wears away with age. This leads to pain and swelling in some cases when bone spurs are formed along the edges of the joint. When ligaments get tight, bone spurs could be formed. Activities such as dancing and running that lay stress on the feet, excess weight or poorly fitting shoes could lead to formation of bone spurs.

During such times that long ligament gets inflamed and the bone tries to mend itself, a bone spur can form on the bottom of the heel. Pressure behind the heel from frequently wearing shoes that are too tight can cause bone spur at the back of the heel. This is also popularly called 'pump bump' as women who wear high heels suffer from this.

When tendons move through a narrow space between the top of shoulder and upper arm, they rub on the bones. Bone spurs can form in this narrow area. This can pinch the rotator cuff tendons resulting in irritation, inflammation, stiffness, weakness and pain. This condition is called rotator cuff disorder. It occurs with age and due to repetitive tearing of the tendons, especially among athletes, baseball players and in painters who frequently have to work with arms above their heads. Traumatic injury and poor posture can also be potential bone spur causes and can lead to spine bone spurs.

Bone spur symptoms

Signs and symptoms of bone spurs depend upon their location. A bone spur in the knee is painful to the extent that it can bend your legs and prevent the knee from operating smoothly. A bone spur on the vertebra can narrow the space that contains spinal cord and can cause weakness or numbness in the arms and legs. A bone spur in the hip can make movement painful and reduce the range of the hip joint. Bone spurs in the shoulder can hinder rotator cuff movement. Bone spur in fingers appear as hard lumps under the skin and they can make the joints in the fingers look knobbly. When bone spurs begin to press on other bones or tissues thereby causing a muscle or tendon to rub, they can break that tissue can cause swelling, pain, and tearing. Bone spurs in the foot can cause corns and calluses when tissue builds up to provide an added pad over the bone spur.

Bone spur diagnosis

A bone spur is visible through an x-ray. But it is rare to take x ray just to see whether a person has bone spur or not. For instance if an X ray is taken to evaluate, say, an arthritis problem, bone spurs should be visible. During physical exam the doctor can feel around the joints to determine exactly where the pain comes from.

Treatment of bone spurs

As such bone spurs do not require any treatment unless they cause pain and damage to other tissues. Treatment should be directed at the causes, symptoms rather than the bone spurs themselves. Such treatment aimed at the cause of bone spurs include weight loss to take the pressure off the joints and for stretching the affected area when bone spurs occur in the heel cord or at the bottom of the your feet. In the case of plantar fasciitis and shoulder pain, it is better to get an ultrasound done or deep tissue massage on the advice of a physical therapist. Treatment could include rest, ice, stretching and non steroidal anti inflammatory drugs such as ibuprofen. Learn to protect your joints in case you are suffering osteoarthritis. In case of bone spur on the foot, changing footwear or adding padding or a shoe insert may help. A podiatrist may be consulted if the corns and calluses become bigger problems. A doctor could suggest a corticosteroid injection at the painful area to reduce pain and inflammation if the spur continues to cause symptoms. Bone spurs can be surgically removed or treated as part of surgery to repair or replace a joint when osteoarthritis has caused considerable deformity or if the range of motion becomes limited.

Bunions

Bunion is a common disorder of the foot. Medically, bunions are referred to as hallux valgus, displacement of the great toe towards the other toes. The result is a hard bump or bunion on the inside edge of the toe. Women are more likely to have bunion than men. The exact cause is still unknown but the common causes attributed to developing bunions include:

• When women use pointed-toe high-heeled shoes repeatedly it lays additional stress and pressure on the tissues at the base of the big toe.
  
• Injury to the joint at the base of the big toe.
  
• Inherited faulty mechanical structure of the foot.
  
• Arthritis, especially in older people, increases risk of developing bunions.
  
• Any kind of unnatural pressure on the foot that lasts over an extended period of time can result in bunions.
  
• Weakness of foot ligaments.
  
• Congenital deformities.
  

Symptoms of bunions

Bunions can be categorized into mild, moderate or severe. Having a bunion does not necessarily mean experiencing excruciating or mild pain in the affected area. There are instances when people with severe bunions don’t experience pain and those with mild bunions experiencing a lot of pain. Possible symptoms of bunions include:

• Redness of area surrounding big toe joint
  
• Swelling in the joint of big toe
  
• Difficulty in walking/moving big toe.
  
• Pain in the inner foot margin.
  
• Difficulty or pain while wearing tight foot wear.
  
• Inability to wear normal size shoes.
  
• Development of hammer toe
  
• Corns or calluses
  

• Choosing footwear that is well-fitting and comfortable.
  
• Avoid stilettos. Prefer wedge or a chunky heel.
  
• Two-inch heel is safer than four-inch heel.
  
• Exercise daily to keep muscles of the feet and legs strong and healthy.
  
• Consider switching exercise regime. Frequent runners should try alternating running days with a low-impact sport such as biking, swimming, speed walking, yoga or Pilates.
  
• Wear an orthotic that will absorb the shock of impact feet.
  
• To get relief from pain of bunions while wearing shoes, apply bunion cushions before slipping into shoes and just before retiring to bed apply an ice pack to reduce inflammation.
  
• Take along orthotics while deciding on new shoes.
  

Diagnose bunions

If you suspect the bump on the feet to be a bunion irrespective of whether you experience symptoms or not, it is time to seek medical attention. Gradually, you may find it difficult to walk in the usual footwear.

The health care provider may ask questions related to duration of the bump, associated discomfort being experienced and the genetic factor. After visually examining the affected part, an x-ray may be required to determine possible cause and the stage of the bunion, how severe the bump is. X-rays help understand and assess the anatomy of the feet.

Treating bunions

The results of the x-ray will help health care provider understand the severity of the bunion. Unless a surgery is performed, bunion cannot be permanently removed. Surgery is resorted to only in such cases where the bunion results in excruciating pain and interferes with daily activities. Bunion surgery is done to help restore normal alignment to the toe joint and relieve pain. If the bunion does not cause pain or discomfort certain life style changes may be recommended which would prevent the bunion from getting worse.

• Non-prescription medications to relieve pain and reduce swelling.
  
• Change of footwear.
  
• Using ice to relieve pain and reduce swelling or cold compressors.
  
• Adding shoe inserts to shoes.
  
• Use of bunion night splints and bunion pads to reduce size of bunions.