What is a hammertoe? A hammertoe is a common foot deformity where one or more of your smaller toes (most often the second, third, or fourth) develop an abnormal bend in the joints, causing the toe to curl downwards instead of lying flat. 3 varieties are commonly described based on which joints are deformed: hammertoe, mallet toe, and claw toe. While slight differences are present, hammertoe is the common terminology to describe toe deformity. Hammertoes can start as flexible deformities but may become rigid and fixed over time if not addressed.
What are the common symptoms of hammertoes? The symptoms of hammertoes can vary in severity but often include:
- Pain or irritation: Especially when wearing shoes that rub against the bent toe.
- Corns and calluses: These thickened areas of skin can develop on the top of the bent joint, at the tip of the toe, or between toes due to friction.
- Redness and swelling: The affected joint and surrounding tissue may become inflamed.
- Burning sensation: Some individuals may experience this in the affected toe.
- Restricted toe movement: Difficulty straightening the toe, particularly as the condition progresses and the joint becomes more rigid.
- Difficulty fitting shoes: Finding comfortable footwear can become a challenge.
- In severe cases, open sores (ulcers) may develop over the prominent joint, particularly in individuals with poor circulation or neuropathy.
What causes hammertoes? Hammertoes develop due to an imbalance in the muscles, tendons, or ligaments that normally keep the toe straight. Common contributing factors include:
- Improper Footwear: Consistently wearing shoes that are too tight in the toe box, have high heels, or don’t fit properly can force toes into a bent position.
- Muscle/Tendon Imbalance: An imbalance in the strength of the muscles and tendons that control toe movement.
- Toe Length: If the second toe is longer than the big toe, it may be more prone to bending if crowded in shoes.
- Trauma or Injury: Stubbing, jamming, or breaking a toe can sometimes lead to a hammertoe deformity.
- Arthritis: Certain types of arthritis can affect the joints of the feet and toes.
- Genetics/Foot Structure: Some people are predisposed to developing hammertoes due to their inherited foot type (e.g., flat feet or high arches).
- Age: The risk can increase with age.
- Pressure from a Bunion: A bunion on the big toe can crowd the smaller toes, contributing to hammertoe formation.
How are hammertoes treated? Treatment for hammertoes depends on the severity of the condition and whether the toe is still flexible or has become rigid.
- Conservative (Non-Surgical) Treatments: These are often effective, especially for flexible hammertoes:
- Proper Footwear: Wearing shoes with a roomy, deep toe box to accommodate the bent toe and avoiding high heels or tight, pointed shoes.
- Padding: Using over-the-counter corn pads, moleskin, or other soft cushions to protect the prominent joint and reduce friction.
- Orthotic Devices: Custom or store-bought shoe inserts can help redistribute pressure, support the arch, and address muscle imbalances.
- Splinting/Strapping: A podiatrist may recommend devices to help hold the toe in a straighter position, particularly if it’s still flexible.
- Exercises: Gentle stretching and strengthening exercises for the toe muscles may help maintain flexibility and relieve pain.
- Pain Relief Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help reduce pain and inflammation.
- Professional Corn/Callus Care: A podiatrist can safely trim painful corns and calluses.
- Surgical Treatment:
- If conservative treatments don’t provide adequate relief, or if the hammertoe is rigid and causing significant pain or interfering with daily activities, surgery may be recommended.
- Surgical procedures aim to release the tight tendons, reposition the toe, or remove a small piece of bone to straighten the joint. This might involve tendon releases, capsule loosening (capsulotomy), joint fusion (arthrodesis), or bone removal at the joint (arthroplasty).
- The specific procedure depends on the individual case and the severity of the deformity. Your podiatrist will discuss the most appropriate surgical option for you.
When to See a Podiatrist: If you notice a change in the shape of your toe, experience persistent pain, develop corns or calluses, or have difficulty finding comfortable shoes due to a hammertoe, it’s advisable to consult a podiatrist. Early intervention can often prevent the condition from worsening and may allow for more effective conservative treatment. This is especially important if you have diabetes, poor circulation, or neuropathy, as foot deformities can lead to more serious complications.
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