Bunions and Hammertoes

Bunions and hammertoes are two of the most common progressive foot deformities. Although they affect different parts of the foot in different ways, the conditions are closely related. They share many of the same causes and treatment options, and worsen in similar ways. Although you can develop just one of the other, people with bunions are more likely to develop hammertoes as well, and vice versa.

What Is a Bunion?

BunionA bunion is deformity that affects the great toe. The most notable symptom is a large bump on the side of the foot at the base of the big toe, but this is only one part of the problem. Over time, the entire digit leans out of alignment, with the tip of the big toe moving toward the other toes rather than pointing straight ahead. (In the most severe bunions, the big toe can even cross over the second.) This misalignment pushes the base of the toe in the opposite direction, which is what causes the distinctive bony bump.

(Although less common, the same problem can occur in the fifth toe rather than the first. This is known as a bunionette or tailor’s bunion.)

Bunions can cause pain, soreness, inflammation, and even numbness or burning sensations. Because they change the shape of your feet, severe bunions can cause pain and difficulty when walking. Furthermore, the friction of tight shoes on the bunion can lead to skin problems such as blisters, corns, calluses, or even open sores.

What Is a Hammertoe?

A hammertoe is any toe that becomes “stuck” in a bent or contracted position at either one or both joints. They can occur in any or all of the four smaller toes on each foot, though they are especially common in the second toe.

Hammertoes usually start out very mild. Although the toe remains bent “at rest,” the joint can still flex and you can lay it flat with your fingers or splints. However, untreated hammertoes will become more rigid and painful over time.

As with bunions, hammertoes often lead to pain, inflammation, and burning sensations. Corns, calluses, and open sores can form on the tips and tops of toes, due to pressure and friction from footwear.

What Causes Bunions and Hammertoes?

Several underlying causes and risk factors are common for both bunions and hammertoes:

  • Faulty mechanical foot structure. Certain foot structures are more likely than others to develop bunions or hammertoes, based on the way weight and pressure are distributed. These structures may be inherited genetically, or develop over time through wear and tear.
  • Poorly fitting shoes. Shoes that crowd the toes or push weight to the front of the foot, such as high heels with pointed toe boxes, can accelerate the progression of a bunion or hammertoe.
  • Specific injuries or conditions. Traumatic injuries, such as stubbing or jamming a toe, can destabilize a toe joint and lead to deformity. Inflammatory arthritis is also associated with both conditions.
  • Gender. About 90% of the people with bunions and hammertoes are women. Although your gender won’t cause these conditions per se, women are more likely to wear improper footwear and may be more likely to inherit vulnerable foot structures.

Why Early Treatment Is So Critical

Bunions and hammertoes are progressive deformities that will only get worse with time. Once the toes have started to change position, surgery is the only way to put them back in place.

By intercepting these conditions early, we can put together a conservative treatment plan that will help you keep them from getting worse, or at least slow the rate of progression significantly. This will allow you to engage in full activity without pain. However, if you wait until bunions or hammertoes become serious, surgical reconstruction may be the only viable option remaining.

Treating Bunions and Hammertoes

If possible, our team will implement treatment solutions to help you manage your bunions or hammertoes conservatively. This might include the use of tools such as arch supports, orthotics, toe spacers, padding, splinting, or other techniques. For very minor cases, a new pair of spacious-enough shoes may be all that is required.

Bunions and hammertoes that are causing more severe pain, making walking difficult, or are not responding to conservative treatments may require surgery. Your podiatric surgeon will discuss the procedure with you and go over any options you may have. Bunion and hammertoe surgeries have excellent prognoses, and most patients are very happy with the results of their procedure.

Don’t wait for a bunion or hammertoe to get worse—take action now! To schedule an appointment with the Northwest Extremity Specialists, please contact the office closest to your location.