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Hammertoe

What is a hammertoe?

A hammertoe is a misshapen toe. The middle joint of the toe bends up in a way that makes the toe look like it is forming an upside-down V. The bent joint may rub the top of your shoe. Hammertoes can develop on any toe, but they usually happen in the second toe. Claw toes or mallet toes look a lot like hammertoes, but a different joint in the toe is bent.

Hammertoes usually are not painful at first. When they begin, they can be pushed down to the correct position. These are called flexible hammertoes. After a while, they will not go back to their normal position, even if pushed with the fingers. These are called rigid hammertoes.

How does it occur?

Some causes of hammertoe are:

  • shoes that are too tight or short
  • shoes with high heels
  • injury
  • diseases that affect the nerves and muscles, such as arthritis and diabetes

When shoes do not fit well, over time the pressure of the shoes pushes the toes into a bent position. After a while, the muscles become unable to straighten the toe, even when you are not wearing shoes.

Similarly, when there is damage or disease of the nerves or muscles in the toes, the toe may rest in the bent position until the tendons become permanently shortened and the toe becomes a rigid hammertoe.

The risk of developing a hammertoe increases with age. Women are much more likely to develop a hammertoe than men.

What are the symptoms?

Symptoms include:

  • pain in the affected toe or toes when you wear shoes, which may make it hard or painful to walk
  • a corn or callus on the top of the joint caused by rubbing against the shoe
  • swelling and redness of the skin over the joint
  • trouble finding comfortable shoes.

After a while the toe may become rigid and you will be unable to straighten or move it. With a rigid hammertoe, calluses or corns may form on the bottom of the toe or the ball of the foot, also causing pain.

How is it diagnosed?

Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes.

You may have blood tests to check for arthritis, diabetes, and infection.

How is it treated?

When hammertoes first start and are still flexible, your healthcare provider may splint or tape the toe into the right, normal position. Sometimes padding will be used to change where the weight falls when you walk on the foot. It also helps to wear shoes that are soft and roomy in the toe of the shoes (this part of the shoe is called the toe box). You will need to avoid tight shoes or shoes with high heels. You can use your fingers to stretch your toes and toe joints toward a more normal position. Exercise your toes by trying to pick up marbles with them or by wadding up a towel on the floor with the toes.

If the hammertoes are rigid and cannot move, you can get a special pad for your foot that relieves the pressure on the ball of the foot. Wear shoes that are extra deep (high) in the toe box. A shoe repair shop may be able to stretch a small pocket in regular shoes to make room for the hammertoe.

Loose, extra large shoes may help relieve the pain, but they do not cure the hammertoe. Hammertoes that cause severe pain or have become rigid may need to have 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. Or 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 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.

Possible risks of surgery are infection and numbness in the toe. Also, the surgery may fail and you may need more surgery.

How long will the effects last?

If you do nothing to take care of a hammertoe that is starting to develop, the toe will become rigid and will not go back to a normal position without surgery.

If you are using taping or splinting to prevent a rigid hammertoe, it is likely to take weeks or months before you see much change. It will also take a lifetime of choosing correct shoes to prevent the problem from coming back.

If you have surgery, you may need to stay off your foot for at least a couple of weeks.

How can I help take care of myself?

  • Try to find shoes that are roomy and comfortable.
  • Have a professional pedicure. Sometimes a skilled manicurist can file down a painful corn.
  • See a podiatrist (foot specialist).

How can I help prevent hammertoes?

The best ways to prevent a hammertoe are:

  • Wear shoes that fit well. Shoes should be one-half inch longer than your longest toe. Shoes should be wide enough and the toe box should be high enough to give the foot room to move.
  • Avoid high heels over 2 inches high.
  • If a toe starts to look like a hammertoe, buy shoes that have an extra high toe box. Wear corn pad removers or cushion pads on top of the affected toe
  • See your healthcare provider any time you have foot pain that does not go away quickly or is more than mild pain. Foot pain is not normal.
Developed by RelayHealth.
Published by RelayHealth.
Last modified: 2010-01-13
Last reviewed: 2009-11-02
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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