Deformity of foot & toes

There can be a number of different causes of foot and toe deformity. Some of the most common include:

• Hammertoes – this is where the second, third or fourth toe is bent in the middle or crossed or sticks out at an odd angle. Hammertoes may develop as a result of wearing ill-fitting footwear. The condition can be painful and the toes may develop calluses and corns.
• Bunions – this is a crooked big toe joint. The joint sticks out at the base of the toe, forcing the big toe to turn inwards. Bunions can be hereditary and may also be due to trauma or arthritis. Wearing narrow shoes can also be a contributory factor.
• Heel spurs – these are pieces of bone that develop at the base of the heel bone. They are common in people with plantar fasciitis. They are not painful in themselves although the inflammation and irritation of plantar fasciitis may cause pain.
• Claw/mallet toes – claw toes cause the toes to curl up where the toe meets the foot and downwards from the middle to the end of the joint. The condition can be caused by nerve damage due to diabetes or other health conditions. It can also be due to wearing shoes that are too tight. Mallet toes cause the last joint of the toe to bulge. The condition normally affects the second toe and a corn often develops near the toenail. It is normally the result of arthritis or injury to the toe.
• Gout – this is a form of arthritis that often occurs in the big toe joint initially. The condition causes a build-up of uric acid in the joint tissues and joint fluid. Gout causes the big toe joint to become red, swollen and very painful. It can be exacerbated by diet, particularly red meat and alcohol.

Deformed feet and toes can cause pain and discomfort and may make it difficult to carry out day-to-day activities. Specific symptoms linked to particular conditions are described above. In general, typical symptoms include: obvious abnormalities and deformity, pain, swelling and callusing.

Most types of foot and toe deformity are diagnosed using a physical examination. In some cases, you may be offered other diagnostic tests.

For example, if you are suspected of having gout you may be given a joint fluid test, where fluid is extracted from the affected joint and examined under microscope for evidence of urate crystals. X-rays, ultrasound or CT scans may be used to confirm a diagnosis or rule out other conditions.

Treatments vary depending on the condition and its severity. Treatments for some of the common conditions include:

• Hammertoes – In the early stages you may be able to correct the problem using footpads or inserts. You should avoid wearing shoes that press on your toes. Once the toes are fixed in a bent position you may need surgery. This normally involves removing a small piece of bone to realign the toe joint.
• Bunions – may be treated initially by wearing more comfortable footwear or taking painkilling medication. More severe cases may require surgery.
• Heel spurs – that are not causing pain may not require treatment, although the plantar fasciitis that often causes them will need to be treated.
• Gout – avoiding certain foods can help to prevent an attack and it is important to stay well-hydrated. Ice can help to reduce the swelling and heat of gout. Anti-inflammatories can help to relieve pain and swelling and you may be offered an injection of corticosteroids into the joint. You may also be given medication to help reduce levels of uric acid in your body.