Updated: Aug 13, 2018
When I bring up the term “hammertoe” in the clinical setting, patients tend to cringe and often appear afraid. I am not sure if it is because they are unfamiliar with the condition or they actually know what it is and they are nervous to hear my answer to, “How do I fix it?”.
Unfortunately, the deformity is irreversible without surgery, but there are ways to slow the progression of the deformity down and to help relieve your symptoms, such as pain or the rubbing of your toes inside shoes. Before I discuss treatment options, though, continue reading to first learn what a hammertoe is and how it develops.
What Is a Hammertoe?
A hammertoe is a generalized term to describe a deformity of the toe when it bends, or curls, at the joint level. Depending on the joints involved and which direction they bend (upwards or downwards), different terms are used, including claw toe or mallet toe. The picture at the right shows an example of a hammertoe, where the first toe bone is pointed upwards and the second toe bone is pointed downwards. This often results in a bony prominence along the top of the toe joint between these two bones. The bony bump can become painful or cause a corn to develop if there is irritation, such as rubbing of a shoe.
Why Does a Hammertoe Occur?
There are many reasons your toes may start to curl, including previous trauma or injury, the presence of an underlying condition (e.g. rheumatoid arthritis, diabetes), previous surgery, and abnormal biomechanics.
As a previously mentioned, there is no way to correct a hammertoe unless it is surgically fixed. You cannot do exercises or use pads, spacers, or slings to straighten the toe out again. Therefore, conservative treatment is aimed at trying to slow down the progression of the deformity, protect the toe, and give you pain relief.
Shoe gear – You should wear good, supportive tennis shoes, or walking shoes, as much as possible and avoid barefoot walking and use of flat shoes and flip-flops. You can also try using a shoe with a wider, or larger, toe box to help accommodate for the increased size of the forefoot in the presence of the contractures.
Orthotics – These are devices that go into your shoes to help cushion, support, and control abnormal motions of your feet. They can also help with the alignment of the lower extremity more proximally, including your knees, hips, and back. They can be purchased off-the-shelf or be custom-made to fit your feet.
Pads – Toe sleeves, toe spacers, and toe crest pads are all over-the-counter products that can be used to help pad or off-load the areas of increased pressure. They will not correct the deformity, but they may provide added cushion to the toes while wearing closed-toe shoes.
Anti-inflammatory medications – Over-the-counter pain medications can help with acute exacerbations of pain associated with joint pain. They should not be used long-term, though.
Surgery – Surgery for hammertoes and other similar digital contractures is considered when conservative treatment options have failed. The specific surgical procedure largely depends on the severity of the contracture. It can include tenotomies or tendon transfers, joint arthroplasties or joint fusions.
DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. If you have questions or concerns related to your health, please contact the doctor, or your own healthcare professional.