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Published on November 20, 2017

woman's feet with bunions

Finding Relief from These Pains in the Toe

Don’t go tossing out your shoes just yet if painful bunions or hammertoes cause you pain.

These conditions that affect small joints in your toes have much more to do with your grandparents than your loafers, heels or flats. Both conditions are genetic instabilities in those small bones of the feet – and they can hurt!

But with some expert care, you can get rid of that pain.

“Both bunions and hammertoes are instability issues within the foot, where the joints are not working as they should and can lead to stiffening or misalignment. But both cases are treatable,” said Terence Pedersen, DPM, a podiatrist with Avera Medical Group Podiatry Yankton. “We treat both conditions more in women than in men, and they can happen to anyone of any age – we have had patients as young as 6 who face pain from bunions and hammertoes.”

What They Are – And What They Are Not

Pedersen said while the two conditions are both painful and genetic, there are key differences. Bunions most often affect the big toe, while hammertoe is mainly found in the small toes. Both lead to pain and limited mobility.

“Hammertoes are the biggest challenge in treatment because the area where the problem can lie is so small and the entire body governs its movement,” he said. “When we provide surgical procedures for hammertoes, our priority is pain relief for the joint. “

Hammertoes occur when the joints in one or more toes flex or bend themselves, making the toe bend abnormally. The flexing occurs even when it should not.

Bunions, along with bunionettes, which is what the condition is called when it affects the fifth toe (smallest toe), often look like a bump, and sometimes patients may think a doctor like Pedersen can simply “shave” off the protrusion.

“It’s not a bump, actually. It’s the joint misplaced that leads to that change in appearance, and tendons, ligaments and the bones themselves all can lead the condition to appear or worsen,” he said. “We approach bunions with conservative care options to start, with surgery being at the other end of the treatment spectrum.”

The Spectrum of Treatment Approaches

Pedersen said bunion surgery can often be straightforward, especially in healthier, younger patients, and after efforts with night splints, ice and anti-inflammatory drugs or orthotic devices fail to bring the change patients want.

“Bunion surgeries are usually highly successful, and pain relief is the main goal. If you are not having pain, or it is minor and intermittent, it’s best to try conservative care and wait on surgery for them,” Pedersen said. “Again, it’s a genetic instability issue – so the root cause is in your DNA. There are good non-surgical approaches that can increase mobility and reduce your pain.”

Better shoes with a proper width and arch support can help greatly, Pedersen said. But just like people, every set of toes is unique. Getting help before these conditions lead to a limp, ankle or back pain or heel pain is important.

“Getting your toes checked and then considering possible treatment plans is never a bad idea,” he said. “Like everything in health, timing is crucial and sometimes an earlier approach can change your whole life – from mobility and pain to overall quality.”

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