A Hammer toe
is a toe that is bent because of a muscle imbalance around the toe joints. The imbalance causes the toe to bend at
one or more joints, pushing the middle of the toe upward in a claw-like position. If you notice such changes, it is important to seek proper treatment. Hammer toes never get better without some type
of intervention and the sooner it is treated, the better the outcome.
Those fashionable shoes. Women tend to cram their feet into too-narrow, ill-fitting shoes with little to no arch support. That?s why we see more hammertoes in women than men. Pointy, high-heeled
shoes put severe pressure on the toes and their joints, and they typically have little to no arch support. Neuromuscular diseases can contribute to the development of hammertoe, too. People with
diabetes can be at increased risk for complications from a hammertoe. In diabetics, if a toe has a corn or other ulceration, it indicates there is too much pressure on the toes. In those with poor
blood flow or neuropathy, these lesions can get infected and lead to the loss of a toe or foot unless shoes are modified.
The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may be a bursa under the corn or instead
of a corn, depending on the pressure. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe
is usually flexible, but when longstanding it becomes more rigid.
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear
crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at
the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still
flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the
involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
You should seek medical advice if you have a hammer toe. Here are some things you can do in the meantime. None of these things will cure the hammer toe, but they may relieve the pain and discomfort.
Only wear shoes that are high and broad across the toes. There should be at least 1.5 cm of space between your longest toe and the tip of the shoe. Keep in mind that this could be either your big toe
or your second toe. Don't wear heels higher than 5 cm. Wear the appropriate shoe for the activity you are doing. You can buy non-medicated hammer toe pads. They fit around the pointy top of the toe
joint and help relieve painful pressure. Gently massaging the toe may help hammertoes
relieve pain. Put ice packs wrapped in cloth on the hammer toe to reduce
If your toe is not bendable, your doctor may recommend surgery. The type of surgery that will be performed will depend on the severity of the condition. You should expect blood and urine studies
before the procedure, as well as x-rays of your feet. Your doctor will inject either a local or regional anesthetic. If your toe has some flexibility, the doctor may be able to straighten it by
simply making an incision in the toe to release or lengthen the tendon. If the toe is not flexible, your doctor will probably make the same incision to release the tendon, but he or she may also
remove some pieces of the bone so that the bone can be straightened. A k-wire is placed in the toe to help hold it straight while it is healing. This is taken out after about four weeks.