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Hammertoe is a type of foot deformity where one or more of the four smallest toes arches upward or bends instead of resting flat. If hammertoe is not treated, it can get worse and the toes may become rigid, causing pain and making it hard to walk or wear shoes.

What is Hammertoe?

Hammertoe is a type of foot deformity where the four smallest toes contract instead of resting flat, making the toes bend like the head of a hammer. It’s caused by an imbalance between the muscles and tendons in the toes. Over time, the muscles may get rigid and could require surgery to fix in severe cases.

Hammertoe can be made worse if you wear shoes that don’t fit correctly. It may also be inherited (passed down in the family) or caused by an injury to the foot. A podiatrist, a doctor who specializes in treating foot problems, can help diagnose and treat hammertoe. Treatment methods are usually non-surgical, but surgery might be needed if you have had the condition for a long time and your toes are rigid or painful.

Some cases of hammertoe progress faster than others, and your podiatrist can help you figure out a plan to keep your toes healthy and flexible.

Hammertoe is similar to other foot deformities such as:

  • Claw toe. In this disorder, the rear toe joint is bent upward, and the other joints are bent down, which makes the toe look like a claw.
  • Mallet toe.  In this foot deformity, the joint nearest to the tip of the toe is bent, while in hammertoe the joint closer to the base of the foot is bent.

Hammertoe might happen at the same time as other problems with your feet, including:

  • Bunion. A bunion is a condition where big toe turns inward toward the little toes, causing a bump to form on the outside of the foot below the big toe.
  • Corns and Calluses. Corns and calluses (patches of thickened skin on the feet) occur when there is repeated pressure or friction on your foot, usually as a result of walking too much or walking in shoes that don’t fit the right way.

Symptoms

If you have hammertoe, you might have symptoms, including:

  • Pain in your feet, especially when wearing shoes
  • Calluses or corns that are caused by the toes rubbing against your shoes
  • Swelling or redness
  • Bent toes
  • Open sores that form when the joint contracts too much

When to See a Doctor

If you notice your toes are starting to contract, you should visit a doctor right away. The earlier hammertoe is diagnosed and treated, the better the results of the treatment can be. If hammertoe goes untreated for a long time, it gets much harder to treat without surgery.

Causes

Hammertoe is usually caused by an imbalance between the muscles and the tendons in the toes. Hammertoe can also occur:

  • As the result of wearing shoes that aren’t the right size.
  • After a toe injury
  • As a complication from diseases like arthritis and diabetes
Hammertoe is sometimes inherited (passed down in families). If your mother or father had this or related conditions, you might have a greater chance of getting hammertoe.

Diagnosis and Tests

The first test that a doctor will perform to see if you have hammertoe is a physical examination. During the exam, the doctor will look at your foot and ask you questions about your medical history. The doctor may move your foot and try to measure how much the toes have contracted. Sometimes multiple foot deformities may occur at the same time, so your doctor might also check for similar and related conditions like bunions, mallet toes, or claw toes.

If additional testing is still needed, the doctor may take an x-ray of the foot to see how the joints look underneath the skin. 

Treatments

Hammertoes may be treated with either surgical or nonsurgical approaches. Nonsurgical treatment options include:

  • Different shoes. Wearing shoes that put your toes under too much pressure can cause hammertoe. Stay away from shoes that have pointed toes or are too small. Shoes that have high heels can also damage your toes by forcing your foot forward. Make sure your feet fit comfortably.
  • Medication. If you have severe hammertoe, it can be helpful to take medicine that reduces swelling and pain, such as ibuprofen.
  • Splints. A splint can keep the toes in the correct place and reduce pain.
  • Pads. Putting pads in your shoe can help prevent your toes from rubbing against the shoe and causing sores.
Surgical treatment may be helpful in restoring motion to severely contracted toes. If you have multiple foot deformities, like bunions or mallet toe, your surgeon may want to do several procedures to correct those issues as well.

Prevention

One of the best ways to prevent hammertoe is to buy and wear shoes that fit correctly and provide enough support. It can also help to be aware of genetic factors and plan accordingly if you know you’re at risk.  Don’t hesitate to meet with a podiatrist (foot doctor) if you notice the early signs of hammertoe.