Digital Disorders and Treatments

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 infants born with deformities, to older adults with acquired deformities.

The major culprit of toe deformities in adults is tendon imbalance. When the natural function of the foot is disrupted (through a variety of causes), the tendons may stretch or tighten to compensate. Thus, people with abnormally long toes, flat feet or high arches have a greater tendency to develop toe deformities.

Arthritis that slowly destroys the joint surface is another major cause of discomfort and deformity. Toe deformities also can be aggravated by restrictive or ill-fitting footwear worn for a prolonged amount of time. Or, problems with toe position may occur if a fractured toe heals in a poor position.

Common Deformities

The most common digital deformities are hammertoes, claw toes, mallet toes, bone spurs, overlapping and underlapping toes, and curled toes.

These deformities may or may not be painful. Corns and calluses a buildup of skin on the affected joint, often associated with bursitis (inflammation of small pouches, called bursas, which lie above the joint between the tendon and skin) are perhaps the most noticeable and bothersome symptoms. If deformities are left untreated, the toe's mobility may become limited, and more serious problems, such as skin ulceration and infection, may develop.

Hammertoes

A hammertoe may be flexible or rigid, and may occur on any of the lesser toes. Ligaments and tendons that have tightened cause the toe's joints to buckle, cocking the toe upward. Shoes then rub on the prominent portion of thetoe, leading to inflammation or bursitis. Corns and calluses soon form.

During the early stages, a hammertoe remains flexible, meaning it will straighten when pressure is applied to the buckled area. As time passes, the toe can become permanently buckled or rigid, requiring surgery for correction. Painful calluses on the bottom of the foot may accompany rigid hammertoes because of pressure generated on the joint.

Mallet Toes and Claw Toes

Mallet toes and claw toes are similar in appearance to hammertoes, but joints at different locations on the toe are affected. The joint at the end of the toe buckles in a mallet toe, while a claw toe involves abnormal positions of all three joints of the toe.

Bone Spur

A bone spur is an overgrowth of bone that may occur alone or along with a hammertoe. Pain, corns and calluses are the major symptoms. Left untreated, a bone spur may eventually be accompanied by bursitis or small skin ulceration.

Overlapping and Underiapping Toes

Any one of the toes can overlap or underlap, pushing on adjacent toes and causing irritation.

Overlapping or underlapping of the fifth toe is a common congenital problem that is easily corrected in children. Bunions can cause the second toe to overlap in adults.

Pain, inflammation and small corns or areas of built up tissue may result. The deformity also can interfere with the normal function of the foot, and if left untreated, may lead to enlargement of bone or bone spur formation.