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.

Charcot MarieTooth Disease

Charcot MarieTooth disease or CMT, also called as hereditary motor and sensory neuropathy, is a group of inherited disorders that cause damage to peripheral nerves. The disease is named after three physicians Jean Charcot, Pierre Marie, and Howard Henry Tooth, who researched about the condition. The condition is progressive, meaning, the muscles of the arms and legs of CMT patients become weak over a period of time. CMT is a genetic disorder and is caused by many different gene mutations. Since 1991, 90 different genes causing CMT have been identified and the list continues to grow.

Signs and symptoms

CMT patients usually begin to notice symptoms in adolescence or early adulthood. Charcot MarieTooth disease affects both motor and sensory nerves and hence results into both motor symptoms (weakness and muscle wasting) and sensory symptoms such as numbness and tingling in extremities. Very rare symptoms of CMT include breathing problems, hearing loss, speech and swallowing problems.

• Muscle weakness leading to Foot Drop
  
  
• High-stepped gait
  
  
• Frequent tripping and falling
  
  
• Stork-like legs due to muscle atrophy
  
  
• Dropping things
  
  
• Clumsiness
  
  
• Bone deformities
  
  
• Hammertoes and High arches
  
  
• Decreased deep tendon reflexes
  
  
• Sensory loss

Diagnosis and treatment

Examining patient's medical history and family history forms the basis for diagnosing Charcot MarieTooth disease. After noting down the symptoms, doctor may further order nerve conduction studies, electromyography (EMG), nerve biopsy, genetic testing and bone X-rays. Nerve biopsy might be done to check for appearance of CMT. Genetic testing is used to check for mutations that cause CMT.

CMT is not a fatal disease and people with most forms of CMT have normal life expectancy. However there is no cure for Charcot MarieTooth disease. It only needs to be managed depending upon the symptoms of the patient. Physiotherapy plays a major role in improving the condition of CMT patients. Physical therapy involving stretches and light exercises helps in building muscle strength and preventing atrophy. Depending on the symptoms, orthopaedic devices such as splints and braces may be used to maintain the mobility of the limbs. If the patients have severe foot deformity, it can be rectified through surgery to help them walk with ease. It can be supported with use of orthotics - specialized shoes.

Podiatrist

A Podiatrist is a medical professional who treats disorders of the feet and ankles. They are also referred to as chiropractors. Persons suffering from disorders such as hammertoes, ingrown toenails, calluses, spurs, bunions and other foot problems are treated by a podiatrist. A podiatric physician must have a degree in podiatric medicine.