Hammer Toe

Written by April Kahn | Published on July 25, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Overview

A hammertoe is a deformity that causes your toe to bend or curl downward instead of pointing forward. This deformity can affect any toe on your foot; however, it most often affects the second toe or third toe. Although a hammertoe may be present at birth, it usually develops over time due to wearing ill-fitting shoes or arthritis. In most cases, a hammertoe is treatable.

What Causes a Hammertoe to Form?

Your toe contains two joints that allow it to bend at the middle and bottom. A hammertoe occurs when the middle joint becomes dislocated.

Common causes of this joint dislocation include:

  • a toe injury
  • arthritis
  • a high foot arch
  • wearing shoes that don’t fit properly
  • tightened ligaments or tendons in the foot
  • pressure from a bunion (when your big toe points inward toward your second toe)

Spinal cord or peripheral nerve damage may cause all of your toes to curl downward.

Risk Factors for a Hammertoe

Certain risk factors increase your likelihood of developing a hammertoe. These include:

  • a family history of hammertoes
  • wearing tight or pointy-toed shoes
  • wearing shoes that are too small
  • having calluses, bunions, or corns (thickened layers of skin caused by prolonged/repeated friction)

Wearing shoes that are too small can force the joint of your toes into a dislocated position. This makes it impossible for your muscles to stretch out. Over time, the practice of wearing improperly fitting shoes increases your risk of developing hammertoes, blisters, bunions, and corns.

Signs and Symptoms

A hammertoe causes you discomfort when you walk. It can also cause you pain when trying to stretch or move the affected toe or those around it. Hammertoe symptoms may be mild or severe.

Mild Symptoms

  • a toe that is bent downward
  • corns or calluses

Severe Symptoms

  • difficulty walking
  • the inability to flex your foot or wiggle your toes
  • claw-like toes

See your doctor or podiatrist right away if you develop any of these symptoms.

How Is a Hammertoe Diagnosed?

A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.

How Is a Hammertoe Treated?

Treatment options for a hammertoe are based on the severity of the condition.

Treatment for a Mild Hammertoe

A hammertoe caused by inappropriate footwear can be corrected by wearing properly fitting shoes. If a high arch caused the condition, wearing toe pads or insoles in your shoes can help. These pads work by shifting your toe’s position, which relieves pain and corrects the appearance of your toe.

You can usually use over-the-counter cushions, pads, or medications to treat bunions and corns. However, if they are painful or if they have caused your toes to become deformed, your doctor may opt to surgically remove them.

If you have blisters on your toes, do not pop them. Popping blisters can cause pain and infection. Use over-the-counter creams and cushions to relieve pain and keep blisters from rubbing against the inside of your shoes.

Gently stretching your toes can also help relieve pain and reposition the affected toe.

Treatment for a Severe Hammertoe

If you are unable to flex your toe, surgery is the only option to restore movement. Surgery is used to reposition the toe, remove deformed or injured bone, and realign your tendons. Surgery is normally done on an outpatient basis, so you can return home on the day of your surgery.

How Can I Avoid Getting a Hammertoe?

The number-one hammertoe prevention tip is to wear properly fitting shoes. If your shoes feel too snug, go to your local shoe store and have the length and width of your feet measured.

If you wear high heels, keep the heel height to 2 inches or less. Wearing shoes with high heels increases the pressure on your toes and causes them to bend. It can also cause the formation of corns and a high arch.

What Can I Expect After Treatment?

Once the cause of the hammertoe is successfully treated, it usually goes away without complications. However, waiting too long to seek treatment can cause your surrounding toes to become deformed as the hammertoe forces them out of position.

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