Many disorders can affect the joints of the toes, causing pain and preventing the foot from functioning as it should. People of all ages can have toe problems, from inherited to acquired.
Toe deformities in adults result mainly from an imbalance of the tendons, causing them to stretch or tighten abnormally. People with abnormally long toes, flat feet, or high arches have a greater tendency to develop toe deformities. Arthritis is another major cause of discomfort and deformity. Toe deformities also can be aggravated by poorly fitting footwear, or if a fractured toe heals in a poor position.
The most common digital deformities are hammertoes, claw toes, mallet toes, bone spurs, and overlapping and underlapping toes.
Hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, causing it to resemble a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Causes of hammertoe include improperly fitting shoes and muscle imbalance.
Treatment for the condition typically involves wearing shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions, or non-medicated corn pads may also relieve symptoms. In severe cases, hammertoe surgery may be recommended to correct the deformity.
Claw toe is caused by nerve damage from diseases like diabetes or alcoholism, which can weaken muscles in the foot. The term stems from the toes' appearance-toes that look like claws digging down into the soles. Claw toe may lead to the formation of painful calluses. Claw toe worsens without treatment and may become a permanent deformity over time.
Common symptoms of claw toe include:
- Toes bent upward from the joints at the ball of the foot
- Toes bent downward at the middle joints toward the sole of the shoe
- Corns on the top of the toe or under the ball of the foot
Claw toe deformities are easier to repair when detected early. Splints or tape is used to hold the toes in correct position.
Overlapping /Underlapping Toes
Overlapping toes are characterized by one toe lying on top of an adjacent toe. The fifth toe is the most commonly affected. Overlapping toes may develop in the unborn fetus. Passive stretching and adhesive taping is most commonly used to correct overlapping toes in infants, but the deformity usually recurs. Sometimes they can be surgically corrected by releasing the tendon and soft tissues about the joint at the base of the fifth toe. In some extreme cases, a pin may be surgically inserted to hold the toe in a straighten position. The pin, which exits the tip of the toe, may be left in place for up to three weeks.