Diagnosing Your Condition
Make an appointment with your family doctor. If you've noticed that one or more of your toes are crooked, especially if pain or inflammation is involved, then make an appointment to see your doctor. Your family doctor is well-trained to be able to rule out anything serious (such as a fracture or infection), but remember your family doctor is not joint or foot specialist, so you may need to see a more specialized health professional to get the correct diagnosis. Your doctor may decide to take an X-ray of your foot to get a better idea of the problem. Your doctor may take blood from you and check your glucose levels because foot problems are common for people with diabetes.
Get a referral to an orthopedic specialist. Orthopods are joint specialists who correct joint problems via braces, splints, surgery or other invasive methods. You likely won't require surgery for your crooked toe, but your orthopod can correctly diagnose joint problems, evaluate whether arthritis is a factor and prescribe anti-inflammatories or analgesics (painkillers) if needed. Your orthopedist may also want to take an X-ray, bone scan, MRI or diagnostic ultrasound to ascertain and properly diagnose your foot condition.
Go see a podiatrist. A doctor who specializes in foot problems is called a podiatrist. Podiatrists can perform minor surgeries of the foot, but they usually focus more on foot/arch supports for your shoes (called orthotics), braces and custom made shoes. A podiatrist is a great source of information on the most appropriate shoes for your feet. Physical therapists, chiropractors and naturopaths may also be good sources of information regarding foot/toe conditions and offer natural, non-invasive treatments.
Dealing With Bunions
Take care of the pain. A bunion is a chronically sprained and inflamed joint that forms when the big toe is constantly pushed towards the smaller toes, usually by wearing ill-fitting shoes or shoes that are too narrow (such as high heels). Flat feet also contribute to bunion formation, which can mimic rheumatoid or osteoarthritis because of the inflammation, redness and dull, achy pain involved. As bunions progress, the big toe becomes more crooked and generates more pain, which may lead to limping and other joint problems in the ankle or knee. Over-the-counter anti-inflammatories (such as ibuprofen or naproxen) or analgesics (such as acetaminophen) can combat the swelling and pain caused by bunions. If the pain is severe, stronger medications may be prescribed by your family doctor or orthopod (such as COX-2 inhibitors or morphine-based drugs). Steroid injections directly into the joint can be effective for combating pain and inflammation.
Change your shoes. The vast majority of bunions occur in women who wear shoes that are too narrow. Changing to shoes that have a wider toe box and better arch support can certainly stop the progression and pain of a bunion, but it probably won't straighten the big toe back to its normal position. After giving up high-fashion shoes, if the bunion is still painful and limits activity, then surgery should be considered. You should be able to wiggle your toes while your shoes are on. There should be at least 1/2 inch (1.25 cm) of space between the tips of your big toes and the end of your shoes while standing up. Athletic shoes and walking sandals are generally good choices.
Get a splint. Taping a plastic, wooden or metal splint around the affected toe might help reduce the pain and realign the joint, depending on how long you've had the bunion. Silicone or felt pads worn on the feet or as shoe inserts may also relieve bunion pain, but it depends on the degree of joint damage. Orthopods, podiatrists, physical therapists and chiropractors could all be of help with splints or shoe orthotics. Arch supports and orthotics realign the shape of your foot, correcting balance and weight distribution throughout the muscles of your feet and toes. Massages, gentle stretching and ice baths may also help reduce the pain and dysfunction of bunions.
Consider bunion surgery. Bunion surgery often involves shaving the bone and/or strategically breaking it so it can be set straight. Surgical pins and wires are often needed to hold the toe bones in place while you heal. For severely damaged joints, the joint might be fused together or even completely removed and replaced with an artificial joint. The goal of surgery is pain relief and increased mobility, not to create a "prettier" foot or make it possible to wear high-heel shoes again. If tight, pointy shoes are worn after surgery, then most likely the bunion will come back. Bunion correction is an outpatient surgery. After the surgery, the foot is covered with a bulky, compressive bandage. Bone typically takes six weeks to heal, so wearing a protective boot for a minimum of six weeks after surgery is common. During this time, avoid excessive or unnecessary walking.
Dealing With Dislocations
Get your toe realigned. Toe dislocations are a relatively common consequence of foot trauma, whether it's accidental (such as stubbing your toe) or intentional (such as kicking a soccer ball). A dislocated toe is certainly painful and looks misaligned, but it doesn't usually involve a fracture. Realigning the dislocated toe with some sort of manual procedure or adjustment (practiced by medical doctors, podiatrists and chiropractors), is the most appropriate treatment. Pain relief often follows immediately after treatment. Dislocations don't often spontaneously realign without intervention from a health professional. The longer a joint is dislocated, the greater the chance of permanent ligament and/or tendon damage, so getting treatment soon after injury is important.
Support your toe until it heals. Once your toe joint is realigned again, it's important to support it with a splint or strong medical tape because the ligaments and tendons that keep the joint straight may be temporarily stretched or weakened. As a consequence, the newly straightened toe may be somewhat unstable for a few days until the connective tissues can strengthen. Consider making your own splint with popsicle sticks and trainer's tape.
Strengthen your toe with exercises. Shortly after your dislocated toe has been realigned and stabilized, you should strengthen it with specific exercises. Towel curls (using your toes to crumple up or pick up a towel from the floor) and marble pick-ups (picking up marbles from the floor with your toes) work well for strengthening the tendons and muscles of your toes and foot. Talk to your doctor before beginning a toe exercise routine, especially if you have other medical conditions such as arthritis or diabetes. If these exercises do not work well or are painful to perform, see a physical therapist or podiatrist for more personalized assistance.
Dealing With Other Malformations
Get your hammertoe fixed. Hammertoe, also known as a contracted toe, is a deformity of the second, third or fourth toe caused by a contraction at the most proximal joint, which results in a hammer-like appearance. Hammertoes are usually flexible in the initial stages but may become rigid if they are not treated appropriately. Hammertoes are caused by wearing shoes that are too small or too narrow, or by wearing high heels that put excessive pressure on the muscle groups of the toe. Hammertoe can be fixed by surgery (cutting and stretching the contracted tendon, then placing a metal pin/wire next to the joint for support), or aggressive stretching regimens on a daily basis. Splints and supports can also be effective for alleviating hammertoe. Use your fingers to massage around the toe, then manually pull (stretch) the hammertoe, holding each stretch for several seconds. Continue this routine multiple times daily for weeks or until you see substantial improvement.
Get your claw toe fixed. Claw toe means that your toe becomes hooked in appearance due to contraction (flexion) of the proximal and distal joints, which forces the end of the toe to dig into the shoe's sole. Painful calluses or corns develop at the very end of the affected toe. Claw toes are caused by wearing shoes that are too small and also by some diseases (such as diabetes) or conditions (tendon contractions). Claw toes can also be fixed by similar surgical methods used for hammertoe, which includes cutting and stretching the contracted tendons. Try walking on the tips of your toes, which will cause extension (and stretching) of the contracted tendons/joints.
Get your mallet toe fixed. Mallet toe is similar to claw toe but involves abnormal positioning only at the most distal joint (at the end of the toe). Mallet toe is commonly caused by shoes that are too tight in the toe box or ones that possess high heels. The forces these shoes place on your feet cause unnatural bending of your toes. Mallet toes can also be fixed by similar surgical methods used for hammertoes and claw toes — cutting and stretching the contracted tendons. Every attempt should be made to spread your toes while barefoot. A toe-spacing product can be worn to help re-approximate your toes to the correct anatomical position.
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