Hammer toe is the name given for a toe that’s bent abnormally downward to look like a hammer. It’s the most common deformity to occur in the second, third, or fourth toe, and is often caused by wearing shoes that are too narrow or with very little arch support. This condition can be very painful, but thankfully, is relatively easy to treat.
In most cases, a hammer toe forms when there’s an imbalance in the tendons, ligaments or muscles surrounding the toe. Whilst most people suffering from a hammer toe will still retain movement, if left untreated, they could become locked in place needing surgery to correct them.
Common causes of hammer toe
There are various things that can cause hammer toe. Below are some of the most common ones:
Shoes: Poor fitting shoes that are too narrow in the box force the toes into a flexed position, the same as high-heeled shoes. If worn repeatedly, the toes may become jammed and unable to open fully.
Genetics: Unfortunately hammer toe can be hereditary.
Sex: Women are at a higher risk than men of getting a hammer toe, mainly due to wearing high heels.
Toe length: Hammer toe is more likely to occur when the second toe is longer than the big toe.
Age: The risk of getting hammer toe increases with age.
Injuries: If you break, stub, or jam your toe, you are more at risk of developing hammer toe.
Certain diseases: Those suffering from diabetes or arthritis are more prone to foot problems, including hammer toe.
Symptoms of hammer toe
The most obvious symptom is that the toe will be bent, making it look like a hammer. Other symptoms include the following:
Being unable to straighten the toe
Open sore could develop in more severe cases
Pain, particularly when wearing shoes or while moving.
A burning, swelling, or redness of the toe.
Calluses or corns on the middle joint of the hammer toe.
Complications and when to seek further medical attention
Hammer toe will get worse over time if not treated. Eventually it may become locked into place, requiring surgery to straighten it. As soon as you notice hammer toe you should see a doctor. If you are being treated for the condition already and it worsens or shows no signs of improvement following prescribed treatments, return to your doctor.
In very rare cases, sore may develop on top of the joint of the hammer toe. These could become infected. If you do see any signs of pus or redness around the affected area, seek medical attention.
Treatment for mild cases of hammer toe
Usually, if the toe is still flexible, the following treatments may be recommended:
Gentle stretching of the toe several times a day.
Corn pads and foot straps to ease the pain.
Substituting high heels for low heels with insole inserts.
Exercises such as using the toe to pick up a marble.
Shoe inserts can be custom made to help the symptoms from worsening and relieve some of the pain.
Cortisone injections may be used by the doctor to ease the pain.
Treatment for more severe cases of hammer toe
A doctor may recommend surgery if the hammer toe does not straighten. Surgery will look to reposition the toe while realigning the damaged tendons at the same time. It’s quite a common procedure that’s normally carried out as an outpatient, meaning no hospital stay is necessary.
Typical surgical procedures include:
Tendon transfer: This is where the tendons are moved from under the toe to above the toe to help with straightening it. It’s a procedure that’s often done in conjunction with other surgery options.
Weil osteotomy: Here the metatarsal bone is made shorter and surgical implants are inserted to help with the healing process.
Arthroplasty: In this surgical procedure, half the joint under the damaged toe is removed to help it straighten.
Basal phalangectomy: Here the base of the bone that lies underneath the toe is removed.
Artrodesis: Similar to arthroplasty, but here the whole joint under the damaged toe is removed and a pin or wire is inserted to aid with the healing process.
Prevention
As with any medical condition, prevention is the key. Like most foot problems, hammer toe can easily be avoided by wearing sensible shoes. These type of shoe should have the following:
Adjustability: Try and find shoes that have adjustable laces and straps.
Low heels: Low heels won’t force your foot into an unnatural position, often bending the toes as a result.
Sufficient arch support: Having sufficient arch support will prevent various foot problems.
Sufficient toe room: Avoid pointy shoes at all costs. Make sure your toes have enough room and are properly sized.