Middle toe joint pain, also called hammer toe, occurs when the middle toe joint becomes dislocated and the toe remains bent in the middle. There are two types of middle toe joint pain. With the flexible version you have the ability to manually straighten your toe. With the rigid version you can’t straighten the toe and it can be very painful. Diagnosing your middle toe joint pain will include an exam where a doctor will look for calluses, swelling and redness, and measure stability, flexibility and sensation in the toe.
Symptoms of middle toe joint pain include toes cramping and buckling under, ulcers and infections in the toes, and pain in the affected toe, the base of the toe, or the ball of the foot. You may also experience red and swollen toe joints, pain when using the joint, discomfort on top of your toes, corns on top of toes, calluses under the toes or on the sole of the feet, and trouble finding shoes to fit comfortably.
Causes and Risks
Middle toe joint pain can be caused by toe injury, a foot with a high arch, pressure from a nearby bunion, wearing shoes that don’t fit properly, and tight ligaments or tendons. You can also be born with middle toe joint pain. Risk factors for developing middle toe joint pain include having arthritis, a family history of the condition, wearing high heels or other improper footwear, bunions, corns and frequent calluses.
The type of treatment you need for middle toe joint pain depends on how serious your problem is. It can be treated early by applying splints, cushions, corn pads, straps or custom-molded orthotics to alleviate symptoms and provide arch support. Other treatment includes using moisturizing cream on the toe to keep skin soft and wearing roomier shoes.
Surgery is the treatment for more severe cases of middle toe joint pain. In arthroplasty, a surgeon trims the head of the proximal phalanx bone, allowing the toe to straighten. If this doesn’t work, another surgical procedure called arthrodesis is used. In this procedure, the surgeon removes cartilage from the base of the middle phalanx bone and puts the toe bones together with a removable pin. Eventually the bones fuse together and resolve the middle toe joint pain condition.
After surgery you will need to stay off your feet for a few weeks to recover and prevent complications such as infection, toe numbness, and the need for more surgery. Middle toe joint pain can be prevented in many cases. Prevention methods include avoiding improper footwear such as heels higher than 2 inches, shoes with narrow toe boxes, and shoes that don’t fit properly.