Hammer Toe Pain

Overview

When there?s an imbalance in the muscle and ligament surrounding a toe joint, the effect is a bend in the middle joint of the toe, which causes the whole toe to bend upward. Because the toe is bent in an unnatural way, it?s common for the toe to become irritated and even develop corns. A toe that curls under rather than bends upward is also considered a hammertoe.

Causes

While there are a number of causes, there aren't many specific risk factors for hammertoes, women tend to get these problems more than men, but they occur without rhyme or reason. Diabetics, however, are more likely to get a hammertoe if they have underlying nerve damage in the toes and feet.

Symptoms

A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.

Diagnosis

First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.

Non Surgical Treatment

Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include splinting the toe to keep it straight and to stretch the tendons of the foot. Using over-the-counter pads, cushions or straps to decrease discomfort Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises) Wearing shoes that fit properly and allow toes plenty of room to stretch out.

Surgical Treatment

Treatment of a severe hammertoe that has become rigid includes surgery. What is done during the surgery depends on how misshapen and inflexible the toe is. The surgeon may make a cut over your toe and release the tendon by cutting the tendon away from the bone. The surgeon may remove a small piece of bone from the toe. The surgeon may realign the tendons to reposition your toe or fasten the bones with hammertoes pins. Sometimes the surgeon may have to join the bones in the toe. In this case, you will no longer be able to bend the toe, but the toe will be flat.

Prevention

These tips may help you buy the right shoes. Buy shoes at the end of the day. Your feet are smaller in the morning and swell throughout the day. Don't assume your shoe size hasn't changed. As you age, your shoe size may change, especially the width. Measure both feet and buy for the larger foot. Ask for just the right fit. A shoe repair store can stretch shoes in tight spots.