Bunions & Hammer Toes Specialist

What are hammertoes?

A hammertoe develops when the muscles and ligaments surrounding the joint of the big toe, where it bends when walking, become imbalanced. The middle joint of the toe begins to bend into an abnormal position pointing in toward the other toes and the stays off balance. In most cases, the toe is then exposed to a great deal of rubbing and friction which causes discomfort and aggravation of the skin. Hammertoes can sometimes develop on toes that curl, usually the pinky toe and its neighbor. Since the high-heels and pointed shoes frequently worn by women force the toes into tight confines, increasing the pressure, women can develop hammertoes more frequently than men. People with diabetes or poor circulation can be particularly plagued by hammertoes. There are two types of hammertoes:

• Rigid- The tendons have pushed the toe out of its proper orientation, it is rigid and cannot be moved.
• Flexible- the toe(s) can still be moved at the joint.

What causes hammertoes?

Throughout the body, the muscles work in pairs. The toes are no different, with a set of balanced muscles on either side. When these muscles are no longer in balance, usually when one is stronger than the other, a hammertoe develops. This causes pressure to accumulate on the joints and tendons. This pressure forces the toe into the hammerhead shape. The imbalance is typically the result of:

• Arthritis
• Damage to the toe(s)
• Shoes which don’t fit properly
• Heredity, a person could be prone to inheriting the condition

What are the signs of a hammertoe?

• Indications of a hammertoe include:
• Corns or calluses on joint
• Hard to move toe(s)
• Toe joint is red or inflamed
• Putting on and wearing shoes is painful
• Sore ball of foot under the bent toe
• Discomfort when attempting to move at joint

What treatments are used for hammertoes?

Appropriately fitted shoes, orthotics, and padding can alleviate the pressure on the toe joint and assist it to move back into its correct position. When the hammertoe is very severe, surgery might be required. Surgery will be used when more conventional therapies have not been successful.

For some patients, there is also a minimally invasive option available, which can reduce recovery time and discomfort.

What are bunions?

Bunions occur as a bony hump on the side of the big toe which causes discomfort. The hump causes the big toe to drift inward toward the other toes. The joint where the toe bends when walking is also affected by a bunion and it can make walking painful. Bunions are also susceptible to pressure and friction caused by certain types of shoes and how they rub on the toe. Calluses often develop on the side of the big toe where the shoe is rubbing.

What causes bunions?

Bunions can be hereditary and problems can increase as people age. Compromised or poorly developed foot structure can also contribute to the formation of bunions as well as other situations which put pressure on the toes. Ballerinas frequently develop bunions because of the pointe shoes they wear and many women develop them from wearing high heels and pointed toe shoes. Arthritis also contributes to the development of bunions.

What treatments are used to address bunions?

• First, the severity of the bunion needs to be determined. The doctor will start by ordering x-rays and assessing the patient’s foot. A blood sample may also be collected to determine if arthritis is playing a role. Based on the evaluation, the doctor might suggest:
• Inserts and orthopedic shoes- for milder bunions, switching shoes or inserting orthotic devices into the shoes can assist to move the foot back into its correct position.
• Medications- painkillers and anti-inflammatories can treat the pain and inflammation. Over-the-counter drugs are typically employed first and if unsuccessful prescription medications can be provided. 
• Surgery- when everyday activities and duties are made impossible by the bunion, surgery is typically a must. The surgeon will realign the bone beneath the big toe by creating small incisions in the neighboring ligaments. Wires and screws may be used to hold the toe in place throughout healing, though not very often. Excess bone tissue can also be excised. For most patients, the procedure takes roughly an hour.