Toe Deformities & Forefoot Pain
There are a range of conditions which cause pain in the lesser (smaller) toes and front of the foot such as:
- Hammer toes
- Claw toes
- Bunnionettes
- Tailors Bunion
- Freiberg's Disease / arthritis
- Morton's Neuroma
It is important to understand that any of the lesser toes can be affected by deformity and cause pain in the ball of the foot as well as in the toe itself. Pain in the ball of the foot is also known as “metatarsalgia”.
How is it caused?
There are a number of causes of deformities of the lesser toes which include
- Trauma
- Arthritis
- Rheumatoid disease
- Diabetes
- Congenital deformities
The key to deciding how to treat the deformity usually requires an understanding of why the deformity has happened in the first place.
What are the symptoms?
How is it diagnosed?
Examination of the foot is required and usually an x-ray to assess the severity of the deformity. Occasionally an Ultrasound Scan or MRI is also required depending on the condition being diagnosed.
How is it treated?
What can I do?
Shoes that have a deep toe box can help but may be difficult to find. Insoles, or soft covers for the individual toes can help.
Non-Surgical Treatment
For pain in the bursae (small, protective fluid-filled sacs around the bones and joints) or neuromas, a steroid injection may help. Laser therapy may also help with reduction of pain in patients with long-term foot and ankle pain.
A gait assessment by and orthotist or podiatrist will help to ensure that you have effective insoles to help ease pain whilst walking.
Surgical Options
If the skin is breaking down, it is advisable to have your toes assessed to see if surgery may offer a permanent corrective solution. There are several possibilities.
Minimally Invasive Surgery – may be performed if the toe is fixed in position and it is painful on the top or tip of the toe.
Fusion of The Lesser Toe – is usually performed if the toe is deformed and the joint is also painful.
Tendon Transfer will be performed if the toe is completely mobile and the deformity can be corrected. This will usually only be performed in younger patients.
When Minimally Invasive Surgery (MIS) techniques are performed, both the function and cosmetic appearance of the toes post-surgery is often superior.
When can I expect to be back to normal after surgery?
The lesser toes are much smaller that the rest of the bones in the foot and ankle and so tend to recover slightly quicker. Once your foot has been assessed, your surgeon will be able to discuss with you how you will mobilise after surgery. You are likely to be walking straight after surgery in a protected shoe.
