Reference Library

Hammertoes

A hammertoe is a contracture or bending of the toe at the first joint called the proximal interphalangial joint. This bending causes the toe to look like an upside-down V when looked at from the side. Any toe can be involved but the condition usually involves the 2nd through 5th toes. Hammertoes are more common in females than males.
There are two different types; the flexible hammertoe: these hammertoes are less serious because they can be diagnosed and treated while still in the developmental stage. They are called flexible hammertoes because they are still moveable at the joint. Rigid hammertoes: This variety is more developed and more serious. Rigid hammertoes can be seen in patient with arthritic conditions, and patient who wait too long to seek professional treatment. The tendons in a rigid hammertoe have become tight and the joint misaligned and immobile making surgery the typical treatment.

Causes

A hammertoe develops because of an abnormal balance of the muscles of the toes. This imbalance causes increased pressure on the tendons and joints of the toe leading to its contracture. Arthritis is another factor, because the balance around the toe in people with arthritis is disrupted. Wearing shoes that are too tight can cause the toes to squeeze can also cause a hammertoe to form.

Symptoms

The symptoms of a hammertoe include the following:

  • Pain at the top of the bent toe under pressure from footwear
  • Formation of corns at the top of the joint
  • Redness and swelling of the joint at the contracture
  • Restricted or painful motion of the toe joint
  • Pain in the ball of the foot at the base of the bent toe

What can you do for relief?

  • Apply commercial non-medicated hammertoe pad around the boney prominence to decrease pressure on the area.
  • Wear a shoe with a deep toe box.
  • If the hammertoe becomes inflamed and painful, apply an icepack several times a day to reduce swelling.
  • Avoid heels more than two inches tall.
  • A loose fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking easier.

While this treatment may make the hammertoe feel better, it is not a cure. You should avoid wearing shoes that are too tight or narrow, and if the pain persists, see your podiatrist. If left untreated, hammertoes bend to become rigid, making non-surgical treatment less of an option.

The treatment options your podiatrist may prescribe vary with the type and severity of the hammertoe.

  • Padding and taping: Often Padding and taping are thee first steps in the treatment plan. Padding minimizes pain and allows the patient to continue a normal active life. Taping may relieve the imbalance around the toe and relieve the stress and pain.
  • Medication: Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation.
  • Orthotic devices: Custom shoe inserts made from your podiatrist may be useful in controlling foot function by reducing symptoms and preventing the worsening of the hammertoe deformity.
  • Surgical options: Several surgical procedures are available. For more severe deformities, the surgery will remove the boney prominence and restore normal alignment of the toe joint. Severe hammertoes, which are not fully reducable, may require more complex surgical procedures. Recuperation takes time and some swelling and discomfort are common for a few weeks following surgery. Pain is easily managed with medications prescribed by your podiatrist.

Prevention

There are several things you can do to prevent hammertoes from forming and or progressing:

  • Wear supportive shoes to help prevent deformities. Hammertoes are often due to faulty foot mechanics, especially foot flattening.
  • Wear custom orthotics prescribed by your podiatrist. Orthotics may slow the progression or stop the development of hammertoes.
  • Avoid shoes with narrow or pointed toe boxes that can press the toes.
  • Children should have their shoes properly fitted on a regular basis as their feet outgrow their shoes rapidly. 

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