Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.
Hammertoe usually starts out as a mild deformity and gets progressively worse over time. In the early stages, the hammertoe is flexible and the symptoms can often be managed with noninvasive measures or with minimally invasive in-office surgical procedures. But if left untreated, a hammertoe can become more rigid and will not respond to nonsurgical treatment.
The most common cause of hammertoe is muscle/tendon imbalance around the toe joint which causes the middle joint of the toe to buckle and become stuck in this position. This imbalance, which leads to a bending of the toes, results from mechanical (structural) changes in the foot that occur over time in some people.
A hammertoe may be aggravated by shoes that don’t fit properly. If a toe is too long and is forced into a cramped position when a tight shoe is worn, a hammertoe may result.
Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, a hammertoe is inherited.
Common symptoms of a hammertoe include:
Although a hammertoe is readily apparent, to arrive at a diagnosis, our podiatrists will obtain a thorough history of your symptoms and examine your foot. During your physical examination, our podiatrist may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes.
In addition, we may take x-rays to determine the degree of the deformity and assess any changes that may have occurred.
If you are diagnosed with hammertoe, we will develop an individualized treatment plan suited to your needs.
Hammertoe is a progressive condition that doesn’t go away on its own, and patients should receive early attention. Hammertoe never gets better without some kind of intervention.
There are a variety of treatment options for hammertoe, and your treatment plan will depend on the severity of your hammertoe and other factors.
A number of nonsurgical treatment options can be undertaken, including:
Padding corns and calluses. Our podiatrists can provide or prescribe pads designed to shield corns from irritation.
If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult with your doctor about this option.
Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels–these are conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than 2 inches. Choose shoes that have a least one-half inch of space between your longest toe (keeping in mind this could be either your big toe or second toe) and the tip of the shoe.
Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance, keeping the hammertoe from getting worse and helping to reduce pain.
Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
Splinting/strapping. We may apply splints or small straps to realign the bent toe.
If the toe is flexible and not stuck in position, we can perform in-office minimally invasive surgical procedures. In some cases, usually when the hammertoe has become more rigid and painful or when an open sore has developed, surgery is needed. Surgery can often be done in a surgery center without the need for hospitalization.
In selecting the procedure or combination of procedures for your particular case, our podiatrist will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors.
Often patients with hammertoe have bunions or other foot deformities that can be corrected at the same time. The length of the recovery period will vary, depending on the procedure or procedures performed.
Wearing the right shoes and taking care of your feet is the best prevention from getting a foot problem such as hammertoe.
Everyone should check their feet for foot problems, but if you have diabetes, you should check your feet daily because diabetes can cause poor circulation or numbness in your toes. Check out our page on Diabetic Foot Care to learn more.
Having good circulation is essential for healthy feet. Take stretch breaks after sitting for a prolonged period of time, and when you are sitting down, put your feet up. Foot massages and a warm foot bath are also good ways to take care of your feet (diabetics should follow a different protocol–see link above).
Most importantly, wear sensible shoes. For recommendations on footwear and fit, check out our page on Shoes.
At Peninsula Podiatry, our podiatrists offer a full range of nonsurgical and surgical treatments for hammertoe relief. If you would like to request an appointment with us, please call (360) 443-5632.
