Bunions are bony projections that extend from the side of the big toe at the base of the toe where it joins the foot. They can be caused by long-term wear of shoes that are too narrow in the toe area, or as a result of an inherited foot shape or gait problems. Bunions cause increased friction against the sides of shoes, resulting in painful blisters and calluses. As bunions progress, finding suitable footwear can become a challenge, and mobility may become impaired as a result of increasing pain and joint stiffness. Without proper treatment, the joint will eventually become permanently deformed and arthritic.
Some milder forms of bunions can be treated with a change in footwear to reduce pressure on the big toe joint so the joint can resume its normal position. Splinting and gentle exercises and stretching can help by keeping the joint flexible and reducing inflammation. Custom orthotics are also extremely helpful, reducing pressure on the toe and also preventing callus formation. In some cases, bunions may need to be surgically treated to reposition the toe joint and stabilize it with pins. The joint may also need to be reshaped.
Hammertoes are toes that have become bent into a claw-like shape as a result of tendon tightening at the toe joint. As tendons become tight, they pull on the toe, causing it to bend downward. Hammertoes usually occur in people who wear shoes that are too tight in the toe area or in people with specific foot shapes or gait issues.
Hammertoes can often be corrected with gentle stretching exercises combined with small splints to help loosen tendons and enable the toe to resume its normal position. Custom orthotics designed to support the toe can help ensure the toe remains properly positioned when wearing shoes. In a very few cases, surgery may be needed to reposition the tendons or to reposition or fuse the joint using tiny pins to keep the toe in a stable and normal position.
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