A hammer toe is a very painful foot deformity usually affecting the second toe. This irregularity is so named because the toe is bent at the middle joint, making it resemble a hammer. If left untreated, a hammer toe can become immovable and very uncomfortable. However, there are both surgical and non-surgical treatments that can help relieve the pain and discomfort associated with this disorder.
A hammer toe typically starts out as a mild deformity but gets worse over time. Early on the disorder can be managed through noninvasive procedures, but often the toe becomes more rigid, open sores may form, and the condition continues to deteriorate. It also becomes increasingly difficult to find a comfortable pair of shoes.
The most obvious symptoms of hammer toe are calluses, corns, foot pain and physical deformity. They may also include pain in the toes or feet, particularly the affected toe, when wearing shoes.
The primary reason for a hammer toe is not wearing shoes that fit properly, a situation that usually applies to women. If the toe is bent and held in one position for a period of time, the muscles will tighten, become unable to stretch out, and the toe will become rigid. High-heeled shoes are particularly troublesome because the toes are not only tightly confined, but the individual's body weight is pushing the toes forward into a very limited area in the toe box. The toe then begins to curl up and arch until its nail is almost vertical to the floor.
Other causes for this disorder may include a muscular imbalance, bunions, rheumatoid arthritis or a birth deformity.
The most common treatment for hammer toe is to wear comfortable shoes. The toe area should be high and wide with enough room to accommodate the deformed toes. Non-invasive treatments include trimming corns and calluses, wearing proper footwear, remedial injections into the affected toe, medications and pain relievers. Orthotic devices such as straps, cushions and non-medicated corn pads may also bring relief.
Surgery may be necessary to relieve the chronic pain brought about by the disorder and relax the bent toe joints, allowing them to properly align. The surgery is typically performed on an outpatient basis using a local anesthetic, though it depends on the type and extent of deformity, and the length of recovery will vary according to the type of procedure performed.
To prevent hammer toes from developing, avoid tight, narrow, high-heeled shoes. Proper-fitting footwear should be 1/2-inch longer than the longest toe and have a wide, soft toe, box particularly for individuals with flat feet. Shoes that provide extra depth, room and support help relieve pressure put on feet by standing and walking.
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