5 Most Common Toe & Toenail Issues
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Ingrown Toenails
When a toenail is ingrown, it is curved and grows into the skin, usually at the sides of the nail. If it causes a break in the skin, bacteria may enter and cause an infection. In many people, the tendency for ingrown nails is inherited, but they can also be caused by hitting the toe, too-tight socks and shoes, fungal infections, and improper trimming. To prevent ingrown nails, cut toenails in a straight line and not too short.
Symptoms of an Ingrown Toenails:
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Pain
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Redness
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Swelling
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Warmth in the toe
Treatment:
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Soaking and massaging to reduce inflammation
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Oral antibiotics (if infected)
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Minor in-office surgical procedure
Fungal Toenails
Fungus of the toenails is a common problem that can affect people of all ages, but most notably individuals who are older. Toenail fungus often begins as athlete’s foot, an infection in the skin, and starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance.
Symptoms of Fungal Toenails:
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Yellowish or brownish discoloration of nails
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Thickening and deformity of toenails
Treatment:
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Oral medication
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Topical medication
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Nail removal (in severe cases)
Bunions
Bunions are a progressive disorder. They begin with a leaning of the big toe toward the second toe, gradually changing the angle of the bones and producing the characteristic bump on the side of the big toe. Certain inherited foot types make people prone to developing bunions. Although wearing shoes that crowd the toes will not actually cause bunions, it sometimes makes the deformity get progressively worse, causing symptoms to appear sooner.
Symptoms of Bunions:
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Pain or soreness at site of enlargement
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Inflammation and redness
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A burning sensation
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Possible numbness
Treatment:
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Changes in shoewear (choose wide shoes)
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Padding
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Activity modifications
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Oral pain and anti-inflammatory medications
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Icing
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Injection therapy to treat inflamed tissue
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Orthotic devices
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Surgery (if other options fail to relieve pain)
Bunionettes (Tailor’s Bunions)
A bunionette, also called a tailor’s bunion, is often caused by an inherited faulty mechanical structure of the foot, resulting in the fifth metatarsal bone protruding outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it. Bunionettes are not as common as bunions, which occur on the inside of the foot, but they are similar in symptoms and causes.
Symptoms of Bunionettes:
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Redness, swelling, and pain at site of enlargement
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Occur when wearing shoes that rub against the enlargement, irritating soft tissues underneath skin, producing inflammation
Treatment:
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Shoe modifications (avoid pointed toes and high heels)
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Padding
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Oral pain and anti-inflammatory medications
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Icing
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Injection therapy to treat inflamed tissue
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Orthotic devices
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Surgery (if other options fail to relieve pain)
Broken Toes
It is not true that if you can walk, your toe is not broken. If a broken toe is not treated correctly, serious complications may develop. Broken toes result from a fracture, or break, in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.
Traumatic fractures are caused by a direct blow or impact, such as seriously stubbing your toe.
Symptoms of a Traumatic Toe Fracture:
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Sound at time of the break
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Pain at place of impact that goes away after several hours
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Crooked or abnormal appearance of toe
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Bruising and swelling the next day
Stress fractures are tiny hairline breaks usually caused by repetitive stress (running), abnormal foot structure, deformities, osteoporosis, or improper footwear.
Symptoms of a Stress Fracture:
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Pain with or after normal activity
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Pain that goes away when resting
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Pain at site of fracture when touched
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Swelling but no bruising
Treatment:
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Rest
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Splinting
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Rigid or stiff-soled shoe
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Avoid offending activity
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Surgery (if break is badly displaced)
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Follow-up care (physical therapy and exercises)
Hammertoes
A hammertoe is a bending deformity of one or both joints in a toe (not including the big toe). It usually starts as a mild deformity and gets worse over time. Because of the progressive nature of hammertoes, they should receive early attention, as they never get better without intervention. The most common cause of hammertoes is a muscle/tendon imbalance. Other causes include tight shoes, earlier trauma to the toe, and heredity.
Symptoms of Hammertoes:
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Pain or irritation of affected toe when wearing shoes
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Corns and calluses on toe, between two toes, or on ball of foot
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Inflammation, redness, or burning sensation
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Contracture—deformity and rigidity—of toe
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Open sores (in severe cases)
Treatment:
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Padding corns and calluses
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Changes in shoewear (avoid short, pointed shoes, and high heels)
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Orthotic devices
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Injection therapy to ease pain and inflammation
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Oral pain and anti-inflammatory medications
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Splinting/strapping
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Surgery (if rigid and painful or open sore has developed)
Arthritis (Hallux Rigidus)
A disorder of the joint located at the base of the big toe, hallux rigidus causes pain and stiffness in the joint, making it increasingly difficult to bend the toe over time. Those with fallen arches or excessive pronation (rolling in) of the ankles are more susceptible. Other causes include excessive stooping or squatting, stubbing your toe, rheumatoid arthritis, and gout.
Symptoms of Arthritis:
Early signs...
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Pain and stiffness in big toe during use
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Pain and stiffness aggravated by cold, damp weather
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Difficulty with certain activities (running, squatting)
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Swelling and inflammation around joint
As the disorder gets more serious...
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Pain, even during rest
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Difficulty wearing shoes because bone spurs develop
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Pain in the hip, knee, or lower back
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Limping (in severe cases)
Treatment:
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Shoe modifications
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Orthotic devices
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Oral pain and anti-inflammatory medications
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Injection therapy to reduce inflammation and pain
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Physical therapy
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Surgery (in severe cases)
