Hammertoes

Our Award-Winning Physicians Can Help Treat & Relieve Your Toe Pain & Discomfort

A hammertoe is a contracture (bending) deformity in one or both joints of any of the littlest four toes. The toe remains “stuck” in a bent position at rest, and cannot be straightened using only the toe muscles. This abnormal bending can put pressure on the toe when wearing shoes, which can lead to problems.

Hammertoes usually begin as mild deformities, but they 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 nonsurgical treatment.

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

Causes of Hammertoes

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) or neurological changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that do not fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoes are the result of an earlier trauma to the toe. In some people, however, hammertoes are inherited.

hammertoes illustration

Symptoms of Hammertoes

Common symptoms of hammertoes include:

  • Pain or irritation of the affected toe when wearing shoes.
  • Corns and calluses (a buildup of thickened skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe, and may be soft or hard, depending on their location.
  • Inflammation, rednessm or a burning sensation.
  • Contracture of the toe.

In more severe cases of hammertoe, open sores may form.

Diagnosis

Although hammertoes are readily apparent from a visual inspection, the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot before making an official diagnosis. 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, the foot and ankle surgeon may take X-rays to determine the degree of the deformities and assess any changes that may have occurred.

Hammertoes are progressive, which means they do not go away by themselves and usually they will get worse over time. However, not all cases are alike—some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Nonsurgical Treatment

There are a variety of treatment options for hammertoes. The treatment your foot and ankle surgeon selects will depend on the severity of your hammertoe and other factors.

A number of nonsurgical measures can be undertaken:

  • Padding corns and calluses. Your foot and ankle surgeon 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 your surgeon about this option.
  • Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels, all of which can force your toe against the front of the shoe. Instead, choose comfortable shoes with deep, roomy toeboxes and heels no higher than two inches.
  • Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.
  • Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
  • 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 by the surgeon to realign the bent toe.

When is Surgery Needed?

In some cases, usually when the hammertoe has become more rigid and painful or when an open sore has developed, surgery is needed.

Often, patients with hammertoe 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.

If you have a hammertoe—even if symptoms aren’t yet severe—schedule an appointment as soon as you can with the Waco Foot & Ankle experts. We can help you prevent the condition from worsening and relieve any pain or difficulties you may be currently experiencing. Give us a call today at (254) 776-6995.

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