Claw toe is characterised by deformity of a toe joint, causing the toe to lift above ground and adopt a curled up position, resembling a claw. It is frequently associated with a bunion deformity of the big toe. Commonly affected are the second and third toes but the fourth and fifth toes can be affected too. There can be many causes leading to the condition but the most common and important causes is mechanical stress. Since the feet are the only points of contact between our body and the ground when we are standing upright, our feet constantly absorb pressure from our body weight when we are standing and walking. When there is excessive pressure on the ball of the foot over time, the joint connecting the toe to the foot can become damaged. This damage causes the toe to dislocate upwards and subsequently adopt a claw-like posture. Although mechanical stress is the main cause of claw toe, there are other less common causes too, like arthritis or an untreated injury.

In the modern context, high pressure exerted on the forefoot is commonly attributed to excessive wearing of high-heeled shoes or tight calf muscle which pushes the front of the foot with excessive force against the ground. When a claw toe is formed, pain is often felt in the ball of the foot. The pain is a manifestation of the damage in the dislocated joint also the abnormal high pressures pain can also arise when it rubs against the footwear when walking.

Claw toe do not arise in a matter of days. The formation of a claw toe is usually a long process. In the early stages, the build up of excessive pressure on the forefoot leads to the formation of callosities. These are areas of thickened skin on the ball of the foot which are considered as precursos to claw toes. As the damaged progresses, the foot becomes painful and when the joint gets damaged to the extent where the toe dislocates upwards, a claw is formed. Areas of callosities tend to be painful but can also be painless if the toes have not developed clawing or the joint has not been significantly damaged. Therefore, relying solely on pain as a warning sign to claw toe may be inadequate. One should seek treatment when callosities are noted to have formed, especially for those who often wear high-heeled shoes, since callosities and claw toe are just manifestations of the same disease at different stages.

When callosities are noticed, it is advisable to give the calf muscles regular stretching to reduce the damaging forces under the front of the foot. This is known as “overloading”. Time spent in highly heeled shoes should be rationed. Since it may not be realistic to completely amount of “rest time” for the feet out of the high-heeled shoes may be the returning should be shaved regularly and analgesics can be taken for pain control. Once clawing has occurred, surgery is the only way to correct the deformity. Modern surgery can be performed endoscopically (Key Hole surgery) or through only very small incisions and with low recurrence risk of less than 5%. Despite the availability of very good surgical techniques for the treatment of claw toes, the best advise should be aimed at prevention. As prevention and delaying of disease progression can be achieved by simple lifestlye modifications, it is important for those at risk of developing claw toes to identify the problem early and take preventive measure against clawing.

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Osteoporosis comes from the Greek, meaning “porous bones”. It is a disease in the bone the leads to an increased risk of fracture. Bones become brittle and break easily, even after very little trauma, for example falling at home. This is different from the traumatic fractures that occur after road accidents. The bones that most commonly break are around the wrist, the spine and the hip.

When suffering from osteoporosis the bone mineral density is reduced, the bone micro-architecture deteriorates, and the amount and variety of proteins in the bone is altered. There might not be any symptoms in the early stages of this condition until a fracture occurs. People with osteoporosis may suffer from spinal compression fractures resulting in a loss of height with a stooped back, also known as dowager’s hump.

Osteoporosis is defined by the World Health Organisation as a bone mineral density that is 2.5 standard deviations or more below the mean peak bone mass of average of young, healthy adults. Established osteoporosis includes the presence of a fragility fracture. To decide weather a bone mineral density test is needed or not, you can call us at 6471 2674 for an appointment!

While you can be affected by this bone-weakening disease in any bone in your body, fractures in the hip and spine are particularly serious, due to the fact that these often result in hospitalization or sometimes even death. Over the last 30 years in Singapore, cases of hip fractures have increased five times in women aged 50 and above, and 1.5 times in men of the same age group. Studies have shown that one in every five people with osteoporosis hip fracture died within a year. Those at risk of bisphosphosphonates, strontium ranelate or denosumab. The medications can reduce the chance of getting a fracture by about 50 per cent. All medications can have side effects but patients should take medication if the benefits outweigh the risks. Those who have low bone mineral density, low body weight, on steroids or with a family history of osteoporosis may need medication after consulting doctor.

The disease is split into three categories, classified as primary type one, primary type two, or secondary. The form of osteoporosis most common is women after menopause is referred to as primary type one or postmenopausal osteoporosis. Primary type two osteoporosis may arise at any age and affect men and women equally. This form of osteoporosis results from chronic predisposing medical problem or disease, or prolonged use of certain medications.

Prevention of osteoporosis is important. An adequate intake of calcium is recommended, to build strong bones. You lose calcium on a daily basis via bodily excretions such as urine, faeces and sweat. We also lose it when shedding skin, hair and nails. It is possible to replenish your loss by eating calcium-rich foods. Calcium rich foods include certain dried herbs, cheese, sesame seeds, tofu, almonds and green leafy vegetables. Calcium is better absorbed when taken in small amount throughout the day, so try to spread your calcium absorption. Exposure to the sun helps in the production of vitamin D. If you cannot eat enough naturally you can take supplements.

Apart from diet, other lifestyle changes include doing weight-bearing exercise to strengthen your bones. Tai chi, brisk walking, skipping, dancing, hiking, jogging and aerobics can help to build up your bones and strengthen them. Resistance exercises like weight-lifting, push-ups, and standing and rising on your toes can also help to increase muscles and decrease the risk of falls.

Call +65 6471 2674 (24 Hour) for treatment to your Osteoporosis today.