Deformity of the big toe associated with a bone prominence on the inner side of the toe is referred to as a bunion (hallux valgus). This deformity may be hereditary, and is aggravated by shoe wear. Initially, this condition should be treated by wearing, wider fitting shoes. Surgical correction is recommended if the foot remains uncomfortable despite appropriate modification of shoe wear.
Arthritis of the joint at the base of the big toe is common. This will often cause stiffness, swelling and pain in the joint. This problem may be associated with a bunion deformity or with gout of the joint. The initial management of the problem involves the use of anti-inflammatory medications.
A hammer toe is also known as a claw toe deformity, and is caused by changes in strength of the small muscles in the foot, worsened by tight fitting and high heel shoes. The development of a bunion may also lead to a hammer toe deformity.
There are many causes for arthritis of the ankle joint. Although a variety of non-operative treatments may be tried including a special brace, these are of not usually successful in the long term. For milder forms of arthritis an arthroscopy (key hole surgery) to clean out the ankle joint can offer good relief of symptoms.
Ankle instability after traumatic sprains is a very common condition. After excluding an associated fracture with an X-ray the initial treatment of a sprained ankle involves support of the ankle in a CAM boot and/or ASO lace up ankle brace combined with a physiotherapist led ankle rehabilitation program.
The development of flatfoot deformity in the adult is often the result of a rupture of the tibialis posterior tendon. Usually when this happens the foot will become progressively more deformed over time. Pain and swelling are often noticed on the inside of the foot and ankle.
Plantar fasciitis is a very common condition with at least 10% of the population suffering from it at some point in their life. The symptoms are generally very specific with heel pain often worst in the morning (first step pain) after arising from bed.
Arthritis in the middle part (arch) of the foot is very common. This condition often presents with pain, collapse of the arch of the foot and painful bony spurs on the top of the foot, which can rub in shoes. The arthritis is usually due to wear and tear (osteoarthritis) but can be related to previous trauma or inflammatory conditions such as rheumatoid arthritis.
A Morton's neuroma in the foot causes burning pain in the forefoot that is often associated with numbness most commonly between the third and fourth toes. The symptoms are frequently exacerbated when a high heel or a tight shoe is worn. The nerve swells, and a permanent thickening develops where the nerve rubs beneath a ligament.
Rheumatoid arthritis of the foot causes painful deformities including hallux valgus (bunions), claw toes, and painful metatarsals, as a result of dislocation of the toe joints. Special shoes and inserts can be worn, although surgical correction is often eventually required.
Fractures of the calcaneus (heel bone) are debilitating injuries which if left untreated lead to severe pain, arthritis and deformity. The ideal treatment is carefully planned surgery by repositioning all the bone fragments and restoring the joint surfaces with a plate and screws.
Arthritis of any or all 3 joints below the ankle can cause significant discomfort, pain and disability. Arthritis can result from trauma (such as calcaneal fractures), inflammatory conditions (such as Rheumatoid arthritis) or related conditions such as tibialis posterior tendinosis.
Individuals with a very high arch (cavus foot) may suffer from one of a number of neurological disorders such as Charcot Marie Tooth (CMT) sensory motor neuropathy. Foot deformities are caused by a muscle imbalance in the leg and foot and usually get progressively worse over time.
The Achilles tendon is the largest and strongest tendon in the human body. It is a very important tendon in normal gait (walking). Over time the tendon can wear out, in particular with frequent running/jumping activities, weight gain or increasing age.
Bone and joint deformity associated with diabetes is caused by a lack of sensation in the foot associated with repetitive minor trauma, leading to severe deformity called a Charcot deformity (neuroarthropathy). If left untreated these may lead to ulceration, infection and amputation.
Dr Beischer is the founder and head of the Victorian Orthopaedic Foot & Ankle Clinic at the Epworth Hospital in Melbourne, Victoria. He is currently the Director of Training of Victorian Orthopaedic Registrars in the area of Foot & Ankle surgery.
Dr Cornoiu has a particular interest in bunion and forefoot conditions, the management of plantar fasciitis and foot & ankle arthritic conditions. Dr Cornoiu also, has extensive experience in the management of foot and ankle trauma and fractures.