When a person has Hammer toe
, the end of their toe hammertoe
bends downward and the middle joint curls up. Eventually, the toe
gets stuck in a stiff, claw-like position. When the inside of your shoe rubs against a hammer toe
, corns, blisters or calluses may form on top of the toe
or on the bottom of your foot. This can make walking painful. You may also have pain in the joint where your big toe
joins your foot. Hammer toe
usually affects a person?s second toe
next to the big toe
), but it can affect other toes too.
The muscles of each toe
work in pairs. When the toe
muscles get out of balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on the toe
's tendons and joints. This pressure forces the toe
into a hammerhead shape. How do the toe
muscles get out of balance? There are three main reasons. Genes. you may have inherited a tendency to develop hammertoes because your feet are somewhat unstable, they may be flat
or have a high arch. Arthritis. Injury to the toe
, ill-fitting shoes are the main culprits. If shoes are too tight, too short, or too pointy, they push the toes out of balance. Pointy, high-heeled shoes put particularly severe pressure on the toes.
The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe
will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl
under the foot. In the variation of mallet toe
, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe
, Painful corns on the tops of the toe
or toes from rubbing against the top of the shoe's toe
box, Painful calluses on the bottoms of the toe
or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe
or toes, you should consider consulting your physician. Even if you're not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe
is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).
Non Surgical Treatment
Hammertoes that are not painful (asymptomatic) and still flexible may not require treatment. In mild cases, open-toed, low-heeled, or wider shoes and foam or moleskin pads can provide symptomatic relief by reducing pressure. Taping (strapping) the affected toe
can help to reduce deformity and pain. Physical therapy to instruct patients in exercises that passively stretch tight structures and strengthen weak foot intrinsic muscles is also helpful with mild cases. Periodic trimming (debridement) of corns (clavi, helomata) by a podiatrist can provide temporary relief. Corticosteroid injections are often very effective in reducing pain.
There are several surgical methods to correct a hammer toe
. Your physician will decide which method will be most beneficial to you depending on the severity of your deformity, the direction the toe
is deviating and the length of the affected toe
. Some common surgical methods include. Arthroplasty. To promote straightening, half of the joint located directly underneath the crooked part of the toe
is removed. Arthrodesis (fusion) To promote straightening, the joint directly underneath where the toe
is crooked is completely removed. A wire
or pin is inserted to aid healing. Tendon transfer. Performed alone or in combination with other procedures, a surgeon will take tendons from under the toe
and ?re-route? them to the top of the toe
to promote straightening. Basal phalangectomy. Performed to assist patients with severe stiffness, this procedure removes the base of the bone underneath the toe
. Weil osteotomy. Performed to assist patients with severe stiffness, this procedure involves shortening the metatarsal bone and inserting surgical hardware to aid healing.