Tarsal coalition develops between the tarsal bones found in the back of the foot due to an abnormal connection between two of the tarsal bones. Tarsal bones include the heel bone, the talus and navicular bones above the heel bone, the cuboid in front of the heel bone, and the cuneiform bones that sit in front of the navicular bone and on top of the cuboid bone. Tarsal coalition can occur in one or both feet, resulting in pain and limited mobility. It most commonly results from bone malformation in-utero, but it does not usually cause problems for the affected individual until late childhood or the teenage years. It can also stem from infection, injury, or joint problems such as arthritis.
Symptoms include stiffness, pain, muscle spasms, and fatigue in the legs. Flatfoot can also arise from tarsal coalition. Treatments include orthotics, immobilization, anti-inflammatory medication (ask a doctor before taking any medication), cortisone and/ or anesthetic injections, physical therapy, and surgery if the above treatments are unsuccessful in alleviating pain and other symptoms.
Spurs are outgrowths of bone. In the feet, they most commonly occur in the heel, but they can also grow near the toes and on the joint of the big toe. The spurs usually develop in areas subjected to constant pressure. Bone spurs can become problematic when pain and other foot problems crop up as a result of footwear pressing and rubbing against the affected area, causing irritation, redness, swelling, and inflammation. As the bone spur irritates and inflames the surrounding soft tissue, acute pain and/ or a dull ache are experienced.
Heel spurs, or bone spurs in the heel, occur on the bottom of the heel bone as a result of calcium deposits forming over time. They are quite common and often develop in athletes who frequently run and jump, high-impact activities that cause repeated pressure on the area; they are also common in individuals who stand on hard surfaces for long periods of time. People with high foot arches, diabetes, and excess weight can also be prone to heel spurs. Heel spurs can be prevented through stretches and foot exercises, wearing supportive, well-fitted footwear, and properly warming up before impact activities, all of which reduce tension and stress to the area.
Heel spurs can lead to plantar fasciitis, a condition when the plantar fascia, or band of fibrous tissue that connects the heel bone to the ball of the foot, becomes inflamed.
Treatment for heel spurs includes orthotics, supportive and properly fitting footwear, anti-inflammatory medications (ask a doctor before taking any medication), cortisone injections, and surgery if the condition worsens.
Overlapping and underlapping toes occur when toes are out of position. The conditions can be congenital due to inheritance or the fetus’s in-utero position, or they can develop over time from ill-fitting footwear that constricts or pressures the toes, keeping them bunched rather than flat. It can also stem from a bunion.
An overlapping toe lies across the top of an adjacent toe rather than staying in its straight position. This is most common with the fifth toe. An underlapping toe lies behind another toe; this most commonly affects the fourth and fifth toes. Congenital curly toe is a condition where the toes curl and point to the outside of the foot. It is usually congenital and can be worsened by ill-fitting footwear. As a result of toe overlapping or underlapping, blisters, irritation, corns, and calluses may form as the toes rub against one another and footwear.
Treatment for overlapping and underlapping toes involves stretching and taping the toes, which is usually how the condition is treated in infants. However, the mispositioning usually returns. Surgery to release the tendons and soft tissues at the toe joint at the base of the toe may be necessary, and in severe cases, a pin can be temporarily inserted in the toe to correct its position. With underlapping toes that are inflexible and fixed in position, surgery can remove bone in the toe to improve flexibility.
Metatarsalgia is characterized by acute pain in the ball of the upper foot region, or the area between the foot’s arch and toes. There are five metatarsal bones running down the middle of the foot from the toes to the ankle; when one of the nerves between the metatarsals becomes inflamed, metatarsalgia and its accompanying pain result.
What Are Some Causes of Metatarsalgia?
- Metatarsalgia can occur when uneven or too much pressure is applied to the foot’s metatarsals due to the following conditions:
- Foot injuries
- Weight-bearing sports and exercises, such as running
- Ill-fitting or rigid footwear
- Prolonged standing on hard floors or ground
- Overpronation, or rolling in of the feet when walking or running which causes uneven weight distribution on the feet
- Foot deformities
- Morton’s neuroma
- Aging (degenerates foot bones and pads)
- Weight gain
What Are Symptoms of Metatarsalgia?
- Sudden or increasing pain in the toe and forefoot area, especially during activity or walking barefoot
- Callus formation under the inflicted joint due to pressure
How Is Metatarsalgia Treated?
- Rest the area and restrict sports and physical activity
- Apply ice
- Take over-the-counter anti-inflammatory medications on a temporary basis (ask your doctor first)
- Wear properly-fitting, supportive, and appropriate footwear and orthotics such as arch supports, metatarsal lifts, and inserts
- Eliminate overpronation with appropriate footwear and orthotics
- Lose weight to reduce pressure and stress on the feet
Mallet toe happens when the joint at the tip of the toe remains bent and unable to straighten. The condition, caused by arthritis and bone and muscle imbalances, can be painful due to the toe’s down-turned tip rubbing against footwear, which creates pressure on the toe. Formation of corns on top of the affected toe is common from the friction caused as the toe presses or rubs against the top of the shoe.
High heels and any ill-fitting footwear that puts pressure on the toes can lead to or worsen mallet toe. The condition can also be aggravated by an active lifestyle, sports, and exercise. Mallet toe treatment includes wearing comfortable shoes with a roomy toe box to accommodate the deformity and reduce friction. Supportive gel inserts for the toe area can also relieve irritation, pain, and discomfort.
Jackson-Weiss syndrome is a rare, genetic disorder that affects males and females alike. The disorder causes foot and skull abnormalities due to over-stimulated bone cell growth. On the feet, Jackson-Weiss syndrome impacts the toes, resulting in unusually large, stubby big toes that point inward, fused toe bones, and webbed skin between the second and third toes. Corrective surgery is usually performed on affected infants.
Hammertoe occurs when the second, third, or fourth toe bends at the middle joint, often as a result of wearing ill-fitting shoes. Genetics, arthritis, and muscle imbalance can also cause hammertoe. The affected toe resembles a hammer, which is where the deformity it gets its name. With hammertoe, the toe bends downward, rather than pointing straight forward. Corns or calluses frequently develop at the top of the affected joint or at the toe’s tip from pressure. Hammertoe can cause pain and can lead to loss of flexibility in the toe.
To treat hammertoe, wear comfortable shoes with large toe boxes, as it commonly develops from shoes that are too small, narrow, or high-heeled. It can also result from injury, arthritis, or a high foot arch. Shoe inserts can help when a high arch is the cause. Over-the-counter treatments are available to alleviate the related corns and calluses. Toe stretches can help restore the toe’s correct position, as well as lessen the pain.
Hallux varus is a deformity of the big toe joint that results in the big toe pointing outward, or away from the other toes, whereas a bunion would cause the big toe to lean inward. Hallux varus can be congenital, or it can occur from overcorrective bunion surgery, a tight or short abductor hallucis tendon, or injury.
Aside from the direction of the toe pointing outward, symptoms of hallux varus are pain, redness, and blisters on the toe from it rubbing against footwear. An ingrown nail on the big toe may also develop from pressure. The condition can be treated by stretching and splinting the abductor hallucis tendon. For more severe cases, surgery can straighten the toe.
Hallux rigidus is a degenerative arthritis affecting the joint of the big toe that eventually causes the toe to become rigid, or unmovable. Over time, the toe’s motion decreases due to wear-and-tear that deteriorates the articular cartilage, making it difficult to walk, run, or climb stairs, all of which involve pushing off of the big toe. In time, standing or putting weight on the affected area can become painful. Hallux rigidus starts with hallux limitus, which involves stiffness and a limited range of motion of the big toe joint.
As a result of hallux rigidus, bunions, calluses, and bone spurs can develop on top of the bone. There is also pain and swelling around the affected joint. Treatment for hallux rigidus involves the use of ice, rest, over-the-counter anti-inflammatory medications (ask your doctor first), and cortisone injections at the site. Stiff-soled or rocker-bottom footwear and orthotic inserts may alleviate pressure to the area, and shoes with a larger toe box area may also help. Surgery can become necessary in advanced or painful cases.
Hallux limitus, an arthritic condition of the hallux, or big toe, involves stiffness in the joint at the base of the big toe. Abnormal alignment of the first metatarsal bone is usually the cause of the condition that restricts motion. Injury, overuse, and genetics are other reasons for the development of hallux limitus.
Symptoms include sudden sharp pain, or the gradual development of discomfort and pain over time, as well as swelling and inflammation that are aggravated by pressure from footwear. Hallux limitus can lead to wider spread joint problems, such as hallux rigidus, as well as calluses, bone spurs on top of the joint, and diabetic foot ulcers, if left untreated. Hallux limitus can be treated with orthotic inserts to stabilize and support the area, ice, rest, over-the-counter anti-inflammatory medications (ask your doctor first), and cortisone injections at the site.