Put your best foot forward; avoiding bunions, hammertoes
This story is provided by our sponsor, NewYork-Presbyterian Hospital.
April is Foot Health Awareness Month, a time to give proper attention to what is probably one of the most neglected of all parts of the human body. But when things go wrong with the feet, they can cause serious distress and command immediate attention. Two of the most common problems are bunions and hammertoes.
Bunions
Dr. Stewart Kamen, a podiatric surgeon at NewYork-Presbyterian/Lawrence Hospital Bronxville, explains, “A bunion is a protruding ‘bump’ on the side of the big toe. The visible bump actually reflects changes in the bony framework of the metatarsal bone (the long bone behind the big toe joint). This bone can move over time from its original position, causing the bulge.”
Bunions are often genetic; they may also be caused by a structural deformity of the foot or by arthritis, and occur more often in women. Changes to the metatarsal bone also cause the big toe to lean toward the second toe.
“When this occurs,” says Dr. Kamen, “it further throws the bone out of alignment, worsening the protrusion and bunion ‘bump.’ An inflamed bunion can be painful, and even the roomiest shoes may be uncomfortable.”
In addition, these changes can cause the muscles, tendons, ligaments, and other components of the big toe joint to become contracted and misaligned as well. Over time, it can lead to stiffening of the joint and arthritis, and wearing down the cartilage lining the joint surface.
Dr. Kamen advises: “If bunions interfere with activities, are consistently painful, or the deformity is causing problems in the rest of the foot, surgery should be considered. Although some people feel they can live with the discomfort, if left untreated bunions can lead to other problems, such as hammertoes, inflammation in the ball of the foot, or painful bursitis.”
A foot surgeon can further diagnose the severity of the condition with x-rays.
There is no treatment for the correction of bunions other than surgery — a procedure conducted under sedation and with local anesthetic. The surgeon typically prescribes a medication to keep patients comfortable during the post-operative period, and will monitor the healing progress as well.
Hammertoes
Another common problem affecting the foot is hammertoes, a deformity in which the toe curls downward rather than pointing forward. Most commonly it affects the second or third toe and, although sometimes present at birth, it can develop from arthritic conditions, or from wearing shoes that might be too tight or those with high heels.
Says Dr. Kamen, “Your toe contains two joints that allow it to bend at the middle and bottom; a hammertoe occurs when the middle joint becomes dislocated. The condition is progressive and will not go away by itself, usually getting worse over time. Once evaluated, a treatment plan can be developed that is suited to each patient’s needs.”
In some cases, usually when the hammertoe has become more rigid and painful, surgical techniques to straighten the toes may include buried implants or wire fixation to address the deformities.
“Often patients with hammertoes have bunions or other foot deformities corrected at the same time. In selecting the procedure for a particular case, consideration is taken as to the extent of the deformity, number of toes involved, age, activity level, and other factors,” notes Dr. Kamen.
To help alleviate the pain associated with hammertoes, a doctor can prescribe pads designed to shield corns from irritation, or splints may be applied to realign the bent toe. Most importantly, people with hammertoes should avoid shoes with pointed toes, shoes that are too short, or shoes with high heels – conditions that can force the toe against the front of the shoe. Instead, they should wear comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
“The feet are very important to a person’s overall health and mobility,” says Dr. Kamen, “which is why it is best to check your feet regularly to make sure there are no new problems you may not have noticed before.”
To find a physician, visit nyp.org/lawrence or call 914-787-5000.
This story is provided and presented by our sponsor: NewYork-Presbyterian Hospital.