HAMMERTOE

What are Hammertoes?

Hammertoe is a curvature in one or both joints of your toes. The deformity may occur in on or multiple toes on one or both feet. This condition may involve all lesser digits ie: second, third, fourth and fifth toes. The name comes from a bend in joint in the middle of the toe causing it to resemble a hammer. The reason this condition does not occur in the big toe is because, unlike the other toes, the big toe only has two joints (a bend in this this joint is called a mallet toe). The abnormal curvature causes pressure on the toe causing the toe to hammer down creating pain and calluses on the bottom of the foot.

top view of bunions

Types of Hammertoes

A hammertoe may start as a mild deformity that gets worse over time or may develop as the result of an injury. There are three types of hammertoes, reflecting the progression of the condition. 

Flexible Hammertoes 

  • Appear normal when bearing weight.
  • Joint is mobile and range of motion is normal. 

Semi-Rigid Hammertoes 

  • These may be visible when bearing weight.
  • Range of motion has become to decrease, toe begins to stiffen, but some flexibility remains.

Rigid Hammertoes 

  • Little to no range of motion due to tightening of soft tissues structures (ligaments, joint capsule, tendon attachments) that have tightened.

Early intervention is key due to the progressive nature of this condition. Hammertoes will no resolve on their own.

 

Causes

There are four main causes of hammertoes.

Muscle or Tendon Imbalance

  • Most common cause of hammertoes. 
  • The imbalance is the result of overpowering of small muscles of the foot by the larger muscles of the legs. 

Improper Footwear

  • Shoes that are narrow in the toe box, too short for the foot, or cause increased pressure on the toes.
  • Improper footwear inflames the soft tissue structures causing pain and stiffness in the toe.

Trauma

  • Includes recent or previous injury to the toe or foot.
  • Infection or injury that cause increase internal pressures in the foot may cause hammertoes.

Hereditary

  • Strong genetic component meaning your family members may have hammertoes as well.
  • May present as early onset for other underlying diseases

Symptoms

  • Hammertoes can cause the following symptoms:
  • Pain or irritation of the toe with or without shoes
  • Corns or calluses on the toe, between two toes, or on the bottom of the foot
  • Inflammation, redness, or burning sensation in the toe
  • Inability to straighten the toe
  • Difficulty walking
  • In severe cases, open sores may form on the affected toe

Diagnosis

Hammertoes are likely visible when sitting. While hammertoes will not go away on their own, they do progress at different rates. Podiatrists use imaging to diagnose the severity of the condition. A proper history of your symptoms and physical exam is necessary to discuss available treatment options for the degree of deformity. Your doctor will use your history of symptoms and examination to develop an individualized treatment plan that fits your condition.

Nonsurgical Treatment

Non-surgical treatment may be effective at reducing symptoms of hammertoes during the early stages. There are a variety of treatment approaches that may be used at this stage of the condition. They include:

Padding to Prevent Corns and Calluses

If corns or calluses have formed on the toe, after reducing the painful lesion, your doctor may provide pads that help shield them from further irritation. Before purchasing over-the-counter pads, always consult your doctor. Medicated pads can cause severe skin irritation and, in some cases, may cause a wound on the foot if used. 

Changing Your Footwear

Shoes with pointed toes or narrow toe box, shoes that are too short, or high heels that put pressure on the toes should be avoided. Each of these types of shoes can force your toe against the front of the shoe. Recommended shoes will have a deep, roomy toe box and will allow your toes to sit flat.

Orthotic Devices

Your doctor may be able to provide you with custom orthotic devices to place in your shoes. These might help to control the motion that causes the muscle or tendon imbalance allowing the foot to operate pain free.

 

meeting with patient about gout treatment

Injection Therapy

Corticosteroid injections might be used to reduce pain and inflammation.

Medication

Oral NSAIDs either prescription or over the counter may be used to reduce pain and inflammation.

Splinting or Strapping

Small straps or splints could be applied to help realign the bent toe.

Surgical Treatment

When the hammertoe becomes rigid and/or painful or an open sore has developed, surgery is necessary. Patients will often have other foot deformities corrected during the surgery. Deciding on the proper procedure will depend on the extent of the deformity, the number of toes affected, your age, your activity level, and more. In addition, your recovery period will vary depending on which procedure is chosen. 

Hammertoe Remedies at Keir Foot & Ankle Specialists

When experiencing symptoms in line with hammertoe in Oak Lawn, Beverly, Morgan Park, or Chicago, Keir Foot & Ankle Specialists should be your first call. Our experienced team is here to diagnose your hammertoes and find the best treatment.

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