Hammertoes

Hammer Toe is a contracting or bending of one or both joints of the second, third, fourth, or fifth (little) toes. This can cause the toe to appear like an upside-down V when viewed from the side. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

Hammer Toes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

Types of Hammer Toes
Flexible Hammer Toes

Flexible hammer toes are diagnosed and treated earlier and so are less serious. They are still moveable at the joint.

Rigid Hammer Toes
A more serious condition, rigid hammertoes are often seen in patient with arthritis or in patients who have put off treatment. Surgery is often needed for this type of hammer toe.

Causes
An abnormal muscle/tendon balance in the toes is the most common cause of hammer toe. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.

Hammer toes can be inherited, caused by trauma, or arthritis. Hammer toes can also be caused by and aggravated by  shoes that don’t fit properly. Women are more likely to develop hammertoes than men, with high heels with a cramped toebox being a major culprit.

Symptoms
Common symptoms of hammer toes include:

  • Pain or irritation at the top of the bent toe while wearing shoes.
  • Pain in the ball of the foot at the base of the hammertoe
  • Corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
  • Inflammation, redness, burning sensation, or swelling where the toe contracts
  • In severe cases, open sores may form.

Diagnosis
Although hammertoes are readily apparent, diagnosis includes a thorough history of symptoms and examination of the foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, your podiatrist may take x-rays to determine the degree of the deformities and assess any changes that may have occurred. 

Hammer toes are progressive – they don’t go away by themselves and usually they will get worse over time. However, not all cases are alike – some hammer toes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammer toes, a treatment plan can be developed that is suited to your needs.

Non-surgical Treatment
There is a variety of treatment options for hammer toe depending on the severity of your hammer toe and other factors.

  • Padding corns and calluses.Our podiatrists provide or prescribe pads designed to shield corns from irritation. Our office recommends Dr. Jill’s Gel Corn Pads for this purpose.
  • Changes in shoewear.Wearing shoes with a wider toe box and heels of one inch or less can help reduce the likelihood of progression of hammertoes. Avoiding shoes with pointed toes, shoes that are too short, or high heels.
  • Orthotic devices.A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance and prevent the worsening of the hammertoe.
  • Toe separators.This device can help relieve the rubbing and irritation between the toes. Again our office recommends Dr. Jill’s Foam Toe Separators.
  • Injection therapy.Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammer toe.
  • Medications.Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
  • Splinting/strapping.Splints or small straps may be applied to realign the bent toe.

When Is Surgery Needed?
In some cases, usually when the hammer toe has become more rigid and painful, or when an open sore has developed, surgery is needed.

Often patients with hammer toe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

To make an appointment with the Foot and Ankle Center of Lake City call us at 206-368-7000 or request an appointment online.