Hammertoes: Symptoms, Causes, Tests, and Treatments

Hammertoe, also known as contracted or rotated toe, is a common toe deformity where the toe bends upward at the middle joint, causing the toe's tip to slant downward instead of lying flat. This condition is more prevalent in women and the elderly, typically affecting the second, third, or fourth toes. Hammertoes develop due to an increasing imbalance in the tendons, ligaments, and muscles of the toe, leading to contraction and bending at one or both of its joints.

Hammertoes can be painful, especially when moving the affected toe or wearing shoes. Without intervention, the condition often worsens over time. In the early stages, the affected toe remains flexible and can be straightened when pressure is applied to the bend. However, the toe may eventually develop a permanent bend and rigidity. Here's what you need to know about hammertoes.

Symptoms

Symptoms of hammertoes can include:

• Toe pain when wearing shoes
• Restricted motion of the toe
• Pain in the ball of the foot
• Calluses at the top of the joint
• Redness, inflammation, or a burning sensation
• Swelling at the joint

Causes

Hammertoes develop due to a growing imbalance in the toe's tendons, ligaments, and muscles over time, resulting in contraction and bending at one or both of its joints.

Factors contributing to hammertoe development include:

• Tight shoes: The most common cause of hammertoe is wearing ill-fitting shoes, like high heels or shoes that are too short or tight, forcing the toe into a bent position. Long-term toe bending can cause the muscles and tendons to shorten, leading to hammertoe deformity.
• Age: The risk of muscle imbalance and weakness increases with age, raising the likelihood of developing hammertoe.
• Injury: A stubbed, jammed, or broken toe may be more prone to developing hammertoe or mallet toe.
• Diabetes: Hammertoe may develop due to nerve damage caused by diabetes, as approximately half of all diabetics experience an irregular gait. Corns or other ulcerations on a toe may indicate excessive strain on the toes for such individuals.
• Arthritis: Inflammation caused by rheumatoid arthritis can damage the joint and supporting ligaments and tissues, resulting in deformities like hammertoes.

Test for Hammertoes

During a physical examination, a healthcare professional will touch and move your foot and toes to observe how the joints react. They will examine your foot to check for a toe bent at the middle joint with tightened muscles. In addition, an X-ray of your toes may be required.

Treatments

Hammer toe treatments include the following:

• Surgery: If your pain is severe, your hammertoe interferes with daily activities, and non-surgical treatments have been unsuccessful, your healthcare professional may recommend surgery. The surgeon may remove the bony protrusion on your toe and align the joint or insert a steel pin to correct your toe's position. Surgery is typically outpatient, allowing you to return home the same day.
• Taping your toes: Taping your hammertoe is a temporary solution that can provide comfort and prevent further damage or discomfort. Your physiotherapist may recommend foot and leg exercises to correct the muscle imbalance.
• Anti-inflammatory medicines: Apply an ice pack to your hammertoe several times per day to reduce swelling and soreness. Nonsteroidal anti-inflammatory drugs may also be helpful. If your pain and swelling are particularly severe, your doctor may administer a steroid injection to your toe joint.
• Shoe inserts: Wearing properly fitted shoes can help treat hammertoe caused by unsuitable footwear. If a high arch caused the condition, using toe pads or insoles in your shoes can help. These pads work by repositioning your toes, reducing pressure, alleviating discomfort, and improving your toe's appearance. Moreover, these shoe inserts help prevent the worsening of hammertoe.

Say Goodbye to Hammertoe Pain

Hammertoe can be a painful and limiting condition that affects your day-to-day activities. The primary cause of hammertoe is ill-fitting shoes that negatively impact the muscles, ligaments, and tendons in the toe. To prevent hammertoe, consider your footwear choices and ensure there is enough room for your toes to move. In extreme cases, surgery may be the only option for relief.