Disorders of the Foot and Toe - Types, Symptoms, and Management

Introduction

Like every other body part and organ, the foot and toe are important. The foot and toes are made up of a complex mix of multiple bones, joints, tendons, ligaments, and muscles. The foot and the toe act as the weight-bearing rigid structure and play a vital role in maintaining balance and stability while standing, walking, running, and performing various activities.

Foot and toe disorders are a very common problem among individuals and may cause significant pain and discomfort, affecting one's ability to walk and perform daily activities. Individuals of all ages may get affected with disorders of the foot and toe of different types.

What Are the Common Disorders of the Foot and Toe?

Disorders of the foot and toe that are commonly seen are as follows:

• Bunion: A bunion is a bony lump or bump that develops alongside the big toe joint causing the big toe to turn inward. Bunionettes, which are smaller bunions, can form at the little toe joint.

• Plantar Fasciitis: Plantar fasciitis is a condition when pain is experienced under one’s foot when the band of tissue (plantar fascia) that connects the heel bone to the toes gets inflamed.

• Stone Bruises: Stone bruises is a foot condition that causes inflammation and pain in the ball of the foot or the heel pad. It is also known as metatarsalgia.

• Corns and Calluses: When the skin tries to defend itself against pressure or friction, it can develop into thick, hardened layers known as corns and calluses at the pressure points.

• Flat Feet: Flat feet, also known as fallen arches or pes planus, is a condition where the arch of the foot collapses, causing the entire sole of the foot to come into contact with the ground.

• Morton's Neuroma: Morton's neuroma affects the ball of the foot, and the condition occurs when the tissues surrounding the nerves in the area become thickened or compressed. Plantar Warts: Plantar warts, caused by human papillomavirus (HPV), are rough, small growths that typically appear on the high-pressure areas of the foot, such as the balls and heels, and are usually painless.

• Hammertoe: Hammertoe is a foot deformity characterized by an abnormal bend that may affect one or more of the smaller toes, typically the second, third, or fourth toe. The affected toe or toes may bend downward at the middle joint, resembling a hammer or a claw.

• Ingrown Toenail: An ingrown toenail (onychocryptosis), is a condition in which the corner or the edge of the toenail grows into the skin. Ingrown toenails are painful and usually get infected.

What Causes Disorders of the Foot and Toe?

Some of the most common causes for disorders of the foot and toe are as follows:

• Overuse of the Foot and Toe: Repetitive use or strain of the feet and toes due to work, sports, or other activities can cause disorders.

• Trauma: Injuries such as fractures, sprains, and strains can cause foot and toe disorders.

• Medical Conditions: Medical conditions such as arthritis, diabetes, and circulatory problems.

• Improper Footwear: Use of too-tight, too-loose, or unsupportive footwear.

• Obesity: Exerts excess strain and pressure on the foot and toe.

• Aging: Wear and tear of foot and toe bones, joints, and muscles.

• Nerve Conditions: Nerve conditions such as neuropathy (damage to the nerve) or neuromas (benign tumors of the nerve).

• Genetics: Certain foot structures or conditions (such as hammertoe) may be inherited from family members.

What Are the Symptoms of Disorders of the Foot and Toe?

Symptoms of foot and toe disorders vary depending on the specific disorder. However, some of the common symptoms include:

• Pain or stiffness in the affected area.

• Swelling and tenderness underneath the foot or in the toes.

• Difficulty walking or standing or various activities.

• Numbness or tingling sensations in the foot and toe.

• Limited flexibility and mobility of the foot and toes.

• Changes in the shape or appearance of the foot or toe.

• Redness on the skin of the foot and toe.

• Thickened skin (calluses) underneath the foot.

How to Diagnose Disorders of the Foot and Toe?

Disorders of the foot and toe are usually diagnosed with a proper medical history, family history, and physical examination because of the distinctive features of each. However, additional diagnostic measures may be required in some cases to confirm the diagnosis, some of which are as follows:

• Physical Examination: Physical examination of the foot and toes includes assessment of the pain, deformities, tenderness, swelling, walking, postural imbalance, or restricted range of motion.

• Imaging Tests: Imaging tests help to identify fractures, joint abnormalities, soft tissue damage, or other underlying issues. Depending on the suspected condition, imaging tests used are:

  • X-Rays of foot and toe.

  • Ultrasound scan.

  • Magnetic resonance imaging (MRI scan).

  • Computed tomography (CT scans).

• Blood Tests: In certain cases, blood tests may be performed to check for specific markers or indicators of certain conditions (such as arthritis).

How to Treat Disorders of the Foot and Toe?

Treatment methodologies for disorders of the foot and toe vary depending on the causative factor as well as the disease condition. Some of the common treatment measures are as follows:

• Rest: Avoid activities that aggravate the pain and allow the foot to rest.

• Ice the Foot: For 15 to 20 minutes, ice is applied to the foot at the site of pain. Icing may be repeated several times a day to get pain relief.

• Footwear Modification: Wear shoes that provide appropriate cushioning and arch support for the foot and toe and help reduce pressure on the same. It is recommended to use footwear that is wide and low-heeled.

• Orthotics: Use custom shoe inserts (orthotics) to help provide additional support and cushioning to the foot. One may also use pads or tape to cushion, alleviate pain, and prevent further irritation.

• Physical Therapy: Physical therapy includes specific exercises and stretches to help reduce pain and improve flexibility.

• Medications: In order to help reduce pain and inflammation medications may be prescribed.

  • Acetaminophen or Ibuprofen are commonly used medications that help reduce pain and inflammation.

  • Antibiotics may also be prescribed in the presence of any infection (such as ingrown toenails).

  • Steroidal (corticosteroid) injections may be used at the site of pain on the foot in severe cases and when the other treatment measures fail to alleviate the pain and discomfort.

• Ultrasonic Therapy: Using ultrasound imaging for guidance, a needle-like probe is inserted into the site of pain. Rapid vibration is produced by the tip of the probe, which effectively breaks up the damaged tissue and is then suctioned out.

• Surgery: Surgical procedures vary depending on the type and extent of the foot and toe disorder. Some of the common surgical interventions are as follows:

  • Bunionectomy: This involves removing the bony bump (bunion) and realigning the affected joint.

  • Osteotomy: This procedure involves cutting and realigning the bone to correct the deformity.

  • Hammertoe Surgery: Hammertoe is a condition where one or more toes become permanently bent. Surgical correction may involve releasing or repositioning the tendons, removing bone fragments, or fusing the joints.

  • Ingrown Toenail Surgery: For recurrent or severe cases of ingrown toenails, a surgical procedure may be performed to remove a portion or the entire nail, along with any infected tissue.

  • Neuroma Excision: In the case of Morton's neuroma, a surgical procedure may involve removing the affected nerve or releasing pressure on the nerve.

  • Plantar Fascia Release: In some cases, to improve the flexibility of the foot and to relieve pain, surgery may be performed by partially or completely releasing the tight plantar fascia ligament.

For disorders of the foot and toe, it is recommended to seek the evaluation and care of a podiatrist. A podiatrist is a specialized medical professional and has better training and expertise in diagnosing, treating, and managing disorders and conditions related to the foot and ankle.

Conclusion

Disorders of the foot and toe may significantly impact one's life, causing pain, discomfort, and restrictions in mobility. Various options ranging from conservative approaches to surgical interventions, are available to alleviate symptoms, improve foot function, and enhance overall well-being. Prompt diagnosis and appropriate treatment measures are important for managing foot and toe disorders to prevent permanent damage of the same.