Toe problems can be a big inconvenience and quite painful.  These problems are not uncommon and can be a result of wearing too loose or too tight shoes. However, playing sports, running or a blow to the foot damages the toes. Other factors include diseases such as severe arthritis and gout. Some common toe problems are corns and bunions, ingrown toenails, toe joint sprains and dislocations, and fractured toe bones.

While toes are small, and seemingly hidden from view, toe or toenail problems can be a big inconvenience and quite painful. Toe and toenail problems are not uncommon. Often the result of poor footwear, these conditions can cause pain and difficulty walking or wearing shoes. Learn about different toe and toenail problems, and what treatments are available for these conditions.

Causes

Toe problems are often caused by prolonged wearing of poor fitting shoes which have narrow, pointed toe box squeezing the toes into an unnatural position. Problems are also caused by arthritis or polio. Heredity may also play a role. Other factors include bite and sting injuries, broken toe, pinched nerve, stress fractures, tendon rupture, toe sprain, etc. inflammation of the toes cause the symptoms to be present in several toes, one toe or a small part of a toe.

Symptoms

• Sharp, dull, stabbing, burning or throbbing pain
• Numbness
• Weakness
• Stiffness
• Swelling
• Problem in moving the toes

Diagnosis

During consultation, the doctor asks questions to determine what caused the problem. The patient is expected to tell how and when it started, how it is affecting, what’s bothering and what can be done. A physical examination may be performed to evaluate other injuries. The toes are examined at rest, with weight and without weight bearing movement. The foot is also examined to see if there’s any deformity, tender spot or differences in the bones of the foot. In another test, the doctor holds or moves the foot and ankle against resistance. Lastly, x-ray, MRI or bone scan of the bone is done to determine abnormality of the bone or soft tissue.

Treatment

Toe problems that are not painful are managed by non-surgical techniques such as switching to properly fitting shoes that don’t compress the toes. However, severe cases require surgery. The surgical procedures aim to relieve as much pain and correct deformity. The procedures used area:

• Repair of the Tendons and Ligaments around the Big Toe-The tissues may be too tight on one side and too loose on the other, and creates an imbalance causing the big toe to drift towards the others. Done in combination with osteotomy, the procedure shortens the loose tissues and lengthens the tight ones.
• Arthrodesis-Damaged joint surfaces are removed and screws, wires or plates are inserted to hold the surface together until it heals.
• Exostectomy Resection Arthroplasty- Performed in older people who have severe arthritis or have undergone prior surgery. The damaged portion of the joint is removed creating a flexible scar joint.
• Osteotomy- The joint is surgically cut and realigned.

Recovery

The surgeon will give instructions to follow for the first few weeks after surgery. For the next few weeks, the patient is to regularly visit the surgeon to make sure the foot heals properly. After getting discharged, the patient has to wear a special post-operative surgical shoe or cast to protect foot. For the first few days, the patient will need to use walker, crane or crutches. The surgery may carry risk of infection for which the surgeon prescribes antibiotics.