Causes and Treatment of Hammertoes

A hammertoe is a deformity of either the second, third, or fourth toe. The toe becomes curled at the middle joint, resembling a hammer. Hammertoes can be classified as flexible (able to be easily straightened) or fixed (unable to be straightened). You may notice skin irritation or calluses where shoes rub the top of the toe.

What causes hammertoe?

The most common cause of hammertoe is wearing improper footwear, particularly shoes that are too tight in the toe box. Tight shoes force the toe to stay in a bent position. This causes the muscles to tighten and the tendons to shorten. When left in this position for extended periods of time, the toe muscles can no longer straighten appropriately. High heels can also cause hammertoe because they push your toes forward and crowd them in the toe box. Other causes of hammertoe include trauma, abnormal foot mechanics due to nerve and/or muscle damage from diabetes, arthritis, and stroke.

What is the treatment for hammertoe?

The first line of treatment includes lifestyle changes and conservative remedies when possible. Wearing proper footwear and low-heeled shoes with a deep toe box help. Also, you should choose a shoe made of flexible material with a half-inch space between your longest toe and the inside of the tip of the shoe. Additionally, there are exercises you can do to strengthen your toe muscles, like picking up marbles with your toes.

There are many cushions, straps, and non-medicated pads to relieve your toe symptoms, and your orthopedic foot and ankle surgeon can advise you on which of these suit your individual problem. Talk with your doctor before you attempt self-treatment to be sure that you are choosing the right measure.

Can surgery help my hammertoe?

Surgery is indicated for fixed hammertoe deformities that are painful. Surgery typically involves removing the middle joint of the toe (where the deformity exists) and fusing the toe into a straight position. Sometimes the tendon that pulls the toe up must be lengthened if it prevents complete correction of the deformity. Your orthopedic foot and ankle surgeon will discuss the appropriate procedure for your hammertoe condition. Surgery is typically done on an outpatient basis and can be done with local anesthetic if desired.