There are a wide variety of ailments that can impact the toes. In this article, we are going to discuss five toe conditions and injuries that require treatment.
Toe Fractures
A broken toe most often can be treated conservatively with splinting and occasionally a protective shoe or boot. The deciding factor is if there is significant displacement, malalignment or extension of the fracture into the joint line.
Forefoot Pain
Forefoot pain is commonly called “metatarsalgia” and is thought to occur from mechanical overload (ie, a flexible first ray), long second metatarsal, tight calf muscle (ie, equinus contracture). Typical conservative care includes modified shoes & activities, orthotics, metatarsal padding, and physical therapy.
Hammertoes
Another common complaint in the forefoot is hammertoes. Hammertoes can either be rigid or flexible (ie, you can straighten the toe with your fingers). Flexible hammertoes tend to respond to taping, padding, wide toe box shoes and orthotics. Rigid hammertoes are challenging to treat conservatively but still an attempt of conservative care should be attempted. When the conservative measures fail surgery involves fusing the hammertoe joint (ie, proximal interphalangeal joint) and stabilizing it with a pin that is removed at around 4 weeks.
Bunions
The etiology of bunions is multifactorial, for instance there can be an association with shoe wear and have a hereditary component, regardless of cause, the treatment of bunions should be initiated with conservative care to include modified shoes, orthotics, bunion spacers and splints. Its advisable to obtain x-rays annually to obtain objective evidence if the the bunion is worsening.
Big Toe Arthritis
Hallux rigidus the medical term for arthritis of the big toe joint. It typically arises from an accumulation of “micro trauma” and tends to worsen with time and activity. Conservative treatment includes orthotics, NSAIDs (eg, ibuprofen), modified shoes & activities, steroid injections, and more. However, these tend not to stop the progression of the arthritis.
