Very common and described as a bump on the side of the big toe, but anatomically, a bunion is a visible bump that reflects deviations from the usual bony framework on the feet. What happens is that the big toe leans in the direction of the other toes instead of pointing straight. This toe movement results into a misalignment of the bones (joint at the base of the big toe moves towards the skin) causing a bump.
Bunions are sometimes due to improper wearing of shoes (tight or ill-fitting), arthritis, and certain hereditary bone or foot structure that increases the risk of developing a bunion.
Calluses and Corns
Calluses and corns are areas of the skin that became thick, which happens as a normal physiological mechanism as a response to repeated friction or excessive pressure on the skin. The most common cause of calluses and corns is wearing poorly-fitted shoes. Another causative factor is abnormal pressure on an existing foot deformity.
A corn is often described as a circumscribed demarcated area with a translucent central core. It presses into the dermis (thick layer of tissue which forms the second layer of the skin), that may or may not cause inflammation or pain.
Calluses are a broad area in the skin of relatively even thickness. They are not as circumscribed than corns, and they do not have a central core.
An ingrown toenail is a toenail that pushes and curves downward towards the skin. This ‘growing in’ of the nail makes the skin irritated, oftentimes causing pain, discomfort, redness, and swelling, as well as warmth in the affected toe.
Some people acquire ingrown toenail due to genetics. Some develop this condition due to a foot trauma like hitting on a hard object, repeated pressure on the nails, and wearing dirty footwear or sweaty socks. However, the majority of the cases come from improper cutting or trimming of the nails.
Hammertoe is a condition that involves bending or contracture of one or more middle joints in any of the toes. This abnormal bending creates pressure between the toes and shoes. Symptoms of a hammertoe may include the formation of cor, the presence of calluses, irritation, discomfort, and pain on the affected areas. The most common cause is a tendon or muscle imbalance, causing contracture of the toe.
A claw toe is almost the same as a hammertoe except that with a claw toe, the joint located at the base of the toe is also affected. A claw toe is often caused by a nerve problem secondary to diabetes or as a result of alcoholism. It is a condition that causes dorsiflexion (bending up) of the joint at the base of the toe and flexion (bending down) of the middle joint of the toe
Hallux Rigidus (Stiff big toe)
Hallux rigidus, which simply means “stiff big toe”, is a type of degenerative arthritis which occurs at the base of the big toe. In most cases, a stiff big toe has an unknown cause – it just develops. To some, it develops due to a tremendous stress in the toe like walking or running (athletes). Others acquire it due to an injury or trauma, or as an effect of a medical condition like gout or joint inflammation, and irritation.
Morton’s neuroma is a nerve tissue thickening on the base of the third and fourth toes. It is also known as “intermetatarsal neuroma” because the nerve tissue thickening (neuroma) occurs between (inter-) metatarsal bones. These are the bones running from the midfoot to the toes. The nerve tissue thickening is the result of irritation or compression of the nerve. If not treated, the swelling from irritation and compression may eventually lead to permanent nerve damage.
Inflamed Toe Joint (Synovitis) from Rheumatoid Arthritis
Rheumatoid arthritis is one of the many types of arthritis. It is an autoimmune condition that involves chronic inflammation that is damaging to the joints and other structures. The synovium (inner lining of a joint capsule) is the primary area where the inflammation occurs.
Synovitis can occur at any synovium or joint in the body, but most of the time, the joints of the toes are affected. Symptoms may include warmth, discomfort, redness, swelling, and pain with joint motion. Synovitis or inflammation of the synovium that is left untreated can cause irreversible damage to the bones and cartilages.
If you suspect you have one of these conditions, contact us to discuss different options with one of our podiatrists.
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