Lesser toe problems occur when their shape changes, with “clawing”. This may cause your toes to rub together or against the inside of your shoe, producing pain. Change in shape can also lead to hard skin, known as callus, as well as corns on your feet. You will tend to get corns or calluses at the point where your toes touch the floor or rub on your shoes or against other toes. You might also experience pressure problems underneath the ball of your foot, which is known as metatarsalgia. Below are common lesser problems and their symptoms.
Hammer toes or claw toe deformities cause the toes to be constantly bent, crooked, contracted or deviated from their normal axis. There may be stiffness, as well as redness and swelling in the affected toes. Due to the deformed shape, the toes can feel particularly uncomfortable in shoes.
The symptoms of Morton’s Neuroma involve the foot becoming numb or painful. Pain is typically worse when wearing shoes. Some patients also report a feeling of having their foot ‘falling asleep’, and this usually affects the middle toe and one or other of the neighboring toes.
Sometimes people have toe abnormalities from birth, although most problems develop during adult life or old age. Changes normally happen because of imbalance in the tendons, which changes the shape of the toes and leads to stiffness. More common problems include hammer toe (which is often associated with a bunion) or claw toe, Morton’s Neuroma (which is the swelling of a small nerve in the foot), mallet toe and cross-over toe.
These conditions stem from a muscular imbalance. It tends to become worse over time. Pain is on the prominent top of the toe, where shoes rub, or underneath the ball of the foot where callosities can form.
Over a period of time, often years, the toes begin to be pulled by their tendons if there is imbalance. As a result the toes’ shape starts to change, and they become permanently contracted. As the toes become more and more stiff the discomfort is likely to grow. It is therefore important to see a specialist early on when the condition is detected.
Morton’s Neuroma occurs when the nerve between two bones in the foot becomes irritated or compressed. This can happen as a result of the nerve being pinched between the bones. As a result of the irritation, the area surrounding the nerve, as well as the nerve itself, can become swollen. If untreated, the condition will likely become increasingly painful over time, as the irritation will progressively get worse. Tight shoes exacerbate the condition.
Whether you need surgery or not will depend on what has caused the problem. If the problem looks as if it will get worse over time your foot and ankle surgeon or podiatrist may suggest surgery. However, in some cases, non-surgical options are available to treat these types of conditions.
For a condition like hammer or claw toes, options include advice on footwear, treatment for corns and callosities and protective silicone sleeves to relieve pressure and rubbing. An operation, if needed, aims to correct the deformity. To address the underlying cause a co-existing bunion may need correcting at the same time.
Depending on the specific case, some patients can be treated without surgery while others will need a surgical procedure to address Morton’s Neuroma. Our team of experts will assess your case and evaluate which option is preferable. Insoles and injections should be tried before resorting to surgery to remove the pinched and painful nerve.
There are a number of non-surgical options available to alleviate Morton’s Neuroma. These may include wearing a wider shoe, or a foot-supporting insole in order to help ease the pressure on the affected nerve.
Medication may also be recommended in order to ease the inflammation and reduce the pain.
It is important to carry out this type of treatment as soon as the condition has been identified, as waiting may make it worse.
Surgery is generally employed as a last resort, when the pain becomes too severe and the non-surgical care has not been effective.
The procedure is as a Day Case, so you will able to return home on the same day. The surgeon may try to reduce the pressure on the affected nerve by cutting a part of the surrounding tissue. Alternatively, the surgeon may decide to remove the nerve itself. If the latter option is carried out, a small area of the foot will become permanently numb.
Following surgery, patients need to wear a medical protective shoe to avoid putting pressure on the foot and accommodate the swelling for several weeks.