Hammertoes are a condition where the toe bends downward at the joint of the toe. The toe may bend up at the metarsophalangeal joint, which may cause a slight elevation to the toe, “pointing upward”. This condition is a deformity involving the second, third, fourth and fifth toe. It's uncommon for the “big toe” to be bent this way. Hammertoes are typically bent at the middle joint, causing it to resemble a hammer. If hammertoes are left untreated, they can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Hammertoes are caused by pressure within the joint on the tip of the toe. This may lead to callosities or nail deformity on the tip of the toe. Hammertoes may be flexible, where the principal problem is an overly tight muscle. A flexible hammertoe is where the joints of the toes are still moveable or flexible and can be treated with nonsurgical therapies. A rigid hammertoe is the more serious condition in which the joints' muscles and tendons have lost any flexibility and the contraction cannot be corrected by nonsurgical means. As a result, surgery is generally required to deal with the problem.
A common factor in development of hammertoe is wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Due to these factors, a hammertoe usually occurs much more frequently in women than in men. Other causes or factors in the development of hammertoes can include an injury such as badly stubbing your toe, arthritis and nerve and muscle damage from diseases such as diabetes, joint conditions from osteoarthritis, rheumatoid arthritis, or a stroke. Your feet should be evaluated by a podiatrist to see if you have hammertoes. Podiatrists will look the clinical signs of a hammertoe deformity which also include corns, callouses, redness and swelling on the suspected toe or toes.
The treatment depends on the severity of the hammertoe. After you are evaluated by a podiatrist, he/she may recommend some conservative treatment for your hammertoes depending on the severity of your condition. Conservative treatments include but are not limited to trimming calluses and corn, pad corns and calluses to alleviate pain, changes shoes, avoid pointed toes, high heels, too short or too tight, heels should be no higher than two inches, toe exercises to strengthen the muscles, injections- corticosteroids may ease inflammation, medications (only recommended by your podiatrist) to reduce pain and inflammation, and splints/straps may also be applied to help realign the deformed toe. In severe cases, hammertoe surgery may be recommended to correct the deformity. After surgery you will need to keep weight off your feet while the bone healing process occurs.
Hammertoes are very common and in many cases, conservative treatment that was described above along with physical therapy is enough to resolve the condition. If you are in pain or feel discouraged when you are barefoot in front of others because of your unsightly hammertoes, feel free to come to Dr. Theall’s office, Gentle Touch Foot Care for a full comprehensive and thorough evaluation to discuss your foot health.
For more information, contact our East Orange office at 973-673-FOOT (3668).