Toes can be deformed when subjected to chronic pressure and stress, which is very common when wearing narrow-toed shoes and high heels. The ligaments and tendons surrounding the joints twist, resulting in misalignment and inflammation of the fingers. The big toe is the most affected by these deformations: in this case we speak of hallux valgus. Fingers can also become crooked due to severe trauma; however, there are other malformations that can alter their alignment. If the problem is diagnosed early enough (also based on the cause), it is possible to reverse the deformation with various non-surgical methods; however, if the disturbance persists, corrective intervention in the operating room will be necessary.
Steps
Method 1 of 4: Diagnosing the Pathology
Step 1. Make an appointment with your family doctor
If you have noticed that one or more toes are deformed, especially if the abnormality is accompanied by pain and inflammation, then you need to refer the problem to your doctor. He is able to rule out any serious pathology (such as a fracture or infection), but remember that he is not an orthopedist or podiatrist. For this reason, a specialist visit may be necessary to reach a definitive diagnosis.
- Your doctor may decide to have foot x-rays to get a clearer picture of the problem.
- Blood tests may be needed to check blood sugar, as foot problems are very common among diabetic patients.
Step 2. Ask to be examined by an orthopedist
It is a doctor specialized in the musculoskeletal system who is able to correct joint disorders thanks to braces, splints, surgery or other invasive methods. You probably won't have to operate to fix the problem, but the orthopedist will diagnose the disorder and evaluate if the cause may be arthritis. if so, he may prescribe anti-inflammatories or analgesics, as needed.
In all likelihood, the specialist will give you an x-ray, bone scan, MRI or ultrasound to ascertain the situation and correctly diagnose the disease
Step 3. Go to a podiatrist
This doctor specializes in foot pathologies and can perform basic interventions, but his field of action is more focused on providing support for the feet thanks to orthopedic shoes, custom orthotics, braces and special footwear.
- The podiatrist is able to recommend the most suitable shoes for your feet.
- Physiotherapists, chiropractors and naturopaths can be excellent sources of information regarding foot and toe disorders, and they will also offer you natural and non-invasive treatments.
Method 2 of 4: Managing Bunion
Step 1. Treat the pain
Hallux valgus is permanently distorted and inflamed; this deformation is triggered when the largest toe is constantly pushed towards the smaller toes, as happens when you wear the wrong shoes, too tight at the toe and with a high heel. Flat feet contribute to the development of this deformity, which manifests symptoms similar to those of rheumatoid arthritis or osteoarthritis, as the toe becomes inflamed, turns red, causes dull and continuous pain. As this problem progresses, the big toe becomes more and more crooked, causes more pain, and could even lead to lameness and other joint problems affecting the ankle or knee.
- Over-the-counter anti-inflammatories (such as ibuprofen or naproxen) or pain relievers (such as acetaminophen) are helpful in fighting the swelling and pain caused by bunion.
- If the pain is really intense, you may need stronger medications, which can be purchased by prescription from your family doctor or orthopedist (for example, selective COX-2 inhibitors and morphine derivatives).
- Steroid injections performed directly into the joint are effective for fighting inflammation and pain.
Step 2. Change your footwear
The vast majority of hallux valgus occurs in women who wear shoes that are too tight. If you choose footwear with a wider toe and better arch support, you can definitely stop the progression of the deformation and reduce related pain; however, do not expect the big toe to return to its normal position. If after leaving high fashion shoes the pain does not subside and is disabling, then you will need to consider surgery.
- When wearing shoes you should be able to move your toes.
- There should be at least 1.3 cm of space between the toe of the upper and the toe when standing upright.
- In general, sneakers and hiking sandals are good solutions.
Step 3. Insert a cue
Secure a splint of plastic, wood, or metal to the affected finger using medical tape. This way you should find pain relief and realign the joint at the same time, depending on how long you have been suffering from bunion. Silicone or felt patches wrapped around the area or orthotics can help you get better, but it all depends on the severity of the joint damage. The orthopedist, podiatrist, physiotherapist and chiropractor are all able to prescribe the splint or orthotic that is most suitable for you.
- The insoles and arch supports are able to realign the foot and bring it back to its natural shape, thus correcting the distribution of weight and balance on all the muscles of the fingers and of the foot itself.
- To reduce pain and improve the function of the big toe, you can do massages, gentle stretching exercises or ice-cold foot baths.
Step 4. Consider having surgery to correct bunion
During the operation, the finger bone is usually scraped or broken in a strategic way, in order to bring it back to its natural position. Often pins and metal cables are inserted to keep the bones aligned during healing. When the joints are severely damaged, the bones may be fused together or removed entirely and replaced with prostheses. The goal of surgery is to relieve pain and increase mobility and certainly not to make the foot aesthetically "more pleasing" or to allow you to wear high heels again. If you continue to use narrow, pointed shoes after surgery, you will most likely suffer from hallux valgus again.
- In some cases the surgery is performed in day surgery. The foot is wrapped with a voluminous compression bandage.
- Bone typically heals in 6 weeks, so you will need to wear a protective boot brace at a minimum for this time. At this stage, avoid walking too long or when you don't need to.
Method 3 of 4: Treating a Dislocation
Step 1. Get your toe realigned
Dislocation is a relatively common consequence of trauma, be it accidental (such as when hitting a hard surface) or intentional (kicking a football). This is certainly a painful injury, and the finger appears deformed, but there is no bone fracture. To reduce the dislocation, the doctor (podiatrist or orthopedist) intervenes with a manual procedure or a specific maneuver. There is usually immediate pain relief once the joint is reinserted.
- Dislocations do not subside spontaneously without the intervention of a professional.
- The longer the joint remains in an abnormal position, the greater the risk that the ligament or tendon will suffer irreversible damage. For this reason it is essential to treat the dislocation as soon as possible.
Step 2. Protect and support your finger until it heals
Once the joint has been realigned, you need to protect and support it with a very strong splint or medical tape because, at this stage, the tendons and ligaments that usually keep the joint straight are very weakened and stretched. As a result, the newly treated dislocated finger may be unstable for a few days, during which time the connective tissues are strengthened.
Consider making a homemade stick out of a popsicle stick and sturdy tape
Step 3. Strengthen your finger with exercises
Once the dislocation has been reduced and the joint stabilized, you can strengthen the muscles with specific exercises. Try to pick up from the ground or rub a cloth with your toes; you can also try to lift marbles always using your toes. In this way you stimulate the muscles and tendons of the foot and its toes.
- Before starting an exercise routine, ask your doctor for advice, especially if you suffer from any medical condition such as arthritis or diabetes.
- If these exercises aren't working as they should or are causing pain, see a physical therapist or podiatrist for personalized assistance.
Method 4 of 4: Treating other Deformations
Step 1. Undergo treatment for mallet fingers
It is a deformity of the second, third or fourth toe caused by a contraction of the proximal joint and gives the toe a mallet-like appearance. During the early stages, the affected finger retains some of its flexibility, but over time becomes stiff if not cared for properly. The most common causes of this problem are shoes that are too small or tight, or the habit of wearing only high heels that put too much pressure on the forefoot and toe muscles.
- The mallet finger can be corrected with surgery (by cutting and straightening the contracted tendon and then inserting a pin / wire as a support) or with an "aggressive" regimen of daily stretching exercises. Splints and braces can be effective in relieving the ailments associated with this condition.
- Massage the affected finger area with your fingers and then manually straighten it while maintaining this position for several seconds. Continue this routine several times a day for a few weeks or until you notice substantial improvements.
Step 2. Heal the claw toe
It is a deformity that causes the finger to take on the appearance of a hook or claw and is caused by the flexion of the distal and proximal joints. In this position the tip of the finger is pushed against the sole of the shoe. Painful corns and calluses usually develop on the end of the deformed toe. Claw toes are caused by wearing shoes that are too small, but also by certain diseases, such as diabetes, or ailments such as tendon contractions.
- This deformation is also surgically corrected with a procedure similar to that for the mallet finger: in practice, the contracted tendon is cut and stretched.
- Try to walk on your fingertips to extend and stretch the contracted tendons / joints.
Step 3. Get treatment for hammer toe
This pathology is similar to those described above, but only involves the distal joint (the tip of the finger). Hammer toe often forms due to shoes that are too tight at the toe or those with very high heels. The pressure exerted by these shoes on the toes causes them to bend unnaturally.
- Hammer toes are surgically straightened by the methods described above, by cutting and extending the tendons.
- Try doing some barefoot exercises trying to spread your toes as wide as possible. You can also wear spacers between your fingers to try to bring them back to their natural anatomical position.
Advice
- The most common symptoms associated with crooked toes are: pain (often referred to as aching or burning), swelling and redness, calluses, tendon contracture, shortening of the toe, and a limp.
- To minimize inflammation in the joints, put skin patches or similar products between your fingers to prevent friction.
- If a callus forms on the bunion, take a foot bath with warm water and Epsom salts for about 15 minutes (to soften the skin) before gently exfoliating the thickened area with a pumice stone. It will take 3-5 treatments over a few weeks before getting rid of the hardened callus.
