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OVERVIEW

What is hammer toe?

When a person has hammer toe, the end of their toe bends downward and the middle joint curls up. Eventually, the toe gets stuck in a stiff, claw-like position.

Hammer toe usually affects a person’s second toe (the toe next to the big toe), but it can affect other toes too.

SYMPTOMS

The main symptom of hammer toe is a toe that is bent upward at the middle joint. At first you may still be able to straighten out your toe. But over time, it will become painful and harder to do.

When the inside of your shoe rubs against a hammer toe, corns, blisters or calluses may form on top of the toe or on the bottom of your foot. This can make walking painful. You may also have pain in the joint where your big toe joins your foot.

CAUSES

The most common cause of hammer toe is wearing short, narrow shoes that are too tight. This causes the toe to bend upward. Muscles and tendons in the toe tighten and become shorter. This makes the toe stay in the bent position.

People who are born with long bones in their toes are more likely to develop hammer toe. Children who wear shoes they have outgrown may develop this condition. People who wear very narrow shoes or high-heeled shoes are also more likely to develop a hammer toe.                                                                                                                           

Sometimes, pressure from a bunion can cause hammer toe. Rheumatoid arthritis is another risk factor.

DIAGNOSIS

Your healthcare provider will be able to diagnose hammer toe by doing a physical examination of your foot.

PREVENTION

How can I prevent hammer toe?

Avoid wearing shoes that are narrow or don’t fit well. Also, don’t wear heels higher than 5 cm (2 inches). Instead, choose shoes with a wide toe box that give you 1 cm (½ inch) between the end of your longest toe and the inside tip of the shoe.

To prevent hammer toe in children, check often to make sure your child’s shoes fit, especially when they are having a growth spurt.

TREATMENT

If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your healthcare provider can show you how to do this.

You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best.

If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your healthcare provider may need to give you a steroid injection in the toe joint.

Will I need surgery for hammer toe?

If you have a severe case of hammer toe or if the affected toe is no longer flexible, you may need surgery to straighten your toe joint. Surgery requires only a local anesthetic (numbing medicine for the affected area) and is usually an outpatient procedure. This means you don’t have to stay in the hospital for the surgery.

Living with hammer toe

If your hammer toe is not severe, there are things you can do help your symptoms.

• Wear the right size shoe. Try to avoid shoes that are too tight or too narrow.
• Avoid high heels as much as you can.
• Wear shoes with soft insoles or purchase soft insoles you can insert into your shoes. This will help relieve pressure on the toe.
• Protect the joint that is sticking up by using corn pads or felt pads.