Hammertoes
Overview
What are hammertoes? What do they look and feel like?
“Hammertoes” is a term for progressive symptoms and joint changes that involve one or more of your toes. A hammertoe is a joint on your toe that points up instead of lying flat. This deformity happens because muscles in your foot or leg get weak and the tendons to your toe pull abnormally. You might find that you also have a corn or callus on top of your deformed toe, which may be painful. Eventually, you may be unable to move the affected toe.
What’s the difference between mallet toes, hammertoes and clawtoes?
Each of your feet have 28 bones. Of your five toes, the first (or “big” toe) has two joints: the metatarsophalangeal joint and the interphalangeal joint. The other four have three joints: at the base of your toe is the metatarsophalangeal joint (the first joint), in the middle is the proximal interphalangeal joint (the second joint) and closest to the tip or toenail is the distal phalangeal joint (the third joint).
Hammertoes are sometimes mixed up with mallet toes and clawtoes. There are differences between them:
- Clawtoes: The bend is in the first toe and second joints.
- Hammertoes: The bend is in the second (or middle) toe joint.
- Mallet toes: The bend is in the third toe joint.
What are the types of hammertoes?
There are three types of hammertoes:
- Flexible hammertoes: A flexible hammertoe is still developing, so the affected toes are still able to move at the joint.
- Semi-rigid: The hammertoe is starting to stiffen.
- Rigid hammertoes: A rigid hammertoe can no longer move because the tendons and soft tissues have tightened.
Who is likely to get hammertoes?
Those who wear high heels and unsupportive shoes are more likely to develop hammertoes.
Do hammertoes hurt?
Trying to move the joint may cause pain and you might experience pain in the ball of your foot. Corns and calluses can also be uncomfortable.
Are hammertoes the same things as bunions?
No. A bunion is a bump that forms on the outside of your big toe.
Can hammertoes cause numbness?
No. There is no direct correlation.
Symptoms and Causes
What causes hammertoes?
Abnormal muscle balance in your toe can lead to increased pressure on the tendon and joints, which causes a hammertoe. Causes of that muscle imbalance include:
- Genes: The foot type you’re born with may predispose you to develop this type of joint deformity. Flat, flexible feet can lead to hammertoes as the foot tries to stabilize against a flattening arch. Feet with high arches can also form hammertoes as the extensor tendons overpower the flexors.
- Poor shoes: Too-narrow, ill-fitting shoes, such as high heels, have little to no arch support. High heels put severe pressure on the toes and their joints. That’s why more cases of hammertoes are found in women than men.
- Neuromuscular disease: Neuromuscular diseases can contribute to the development of a hammertoe. People with diabetes can be at increased risk for complications. For them, a toe with a corn or other ulceration indicates there's too much pressure on the toes. In people with diabetes who have poor blood flow or neuropathy, infected corns and lesions can lead to the loss of a toe or foot unless their shoes are modified.
- Trauma: Rarely, trauma to your toe can result in a hammertoe.
What are the symptoms of hammertoes?
Symptoms of hammertoe include:
- A joint in your toe that’s getting rigid.
- Pain – usually at the top of your bent toe.
- Pain in the ball of your foot.
- Corns and calluses at the top of your joint.
- Redness, inflammation, or a burning sensation.
- Restricted or painful motion of your toe joint.
- Swelling at your joint.
- Open sores (rare).
What makes hammertoes worse?
Hammertoes can get progressively worse with time, especially with unsupportive shoes and tendon tightness.
Diagnosis and Tests
How are hammertoes diagnosed?
Your regular healthcare provider may recognize a hammertoe right away. He or she may also send you to a podiatrist, or a foot and ankle surgeon, for a precise diagnosis. That healthcare provider will do a physical examination including touching and moving your foot and toes to see how the joints react. Your toes may need to be X-rayed.
If you have diabetes, you may have to go through tests to figure out if there’s a neurological condition causing a tendon imbalance.
Management and Treatment
How are hammertoes treated? How are they corrected?
Treatments for hammertoes include the following:
- Surgery: Your healthcare provider may recommend surgery if your pain is severe, your hammertoe interrupts your daily activities and/or non-surgical treatments haven’t helped. During the surgery, the surgeon may remove the bony prominence on your toe and align the joint, or insert a steel pin to correct your toe’s position.
- Custom shoe inserts/orthotic devices: These can control how your foot functions.
- Pain relief: Taking anti-inflammatory drugs or getting cortisone shots to alleviate your pain.
- Taping your toes: This can change the muscle imbalance.
- Insulating padding: Padding around the hammertoe can minimize pressure.
What are the risks of treatment?
Risks of surgery include:
- Infection.
- Bleeding.
- Nerve injury.
- Stiffness.
Is the surgery outpatient or inpatient?
Outpatient. You won’t spend the night in the hospital.
How long does it take to recover from surgery?
You may feel stiffness and see some swelling and redness for four to six weeks.
What should I do while I recover from surgery for hammertoes?
Don’t use your toes very much while they heal. Keep your foot elevated.
Prevention
Can hammertoes be prevented? How can I reduce my risk?
- Wear sensible shoes: If you don’t want to have surgery to fix your hammertoe, try non-medicated padding along with proper shoes made with a wider and deeper toebox to accommodate your foot’s shape. A shoe with good arch support can slow the progression of the condition.
- Use a pumice stone: The corn or callus that forms on top of the hammertoe can cause discomfort when you wear shoes. Use a file or pumice stone after a warm bath to reduce the corn or callus' size. Then, apply emollients to keep the area soft and pliable. Use silicone or moleskin padding on top of the area when wearing shoes.
- Do foot exercises: Your podiatrist can suggest exercises for your toes to keep them supple and strengthen the muscles that move them. Extending, then curling the toes, splaying the toes and moving the toes individually may help prevent the contracture that causes hammertoe.
Have your healthcare provider refer you to a podiatrist (a doctor who specializes in feet) if you start to see or feel any trouble.
Outlook / Prognosis
Will hammertoes affect my walking? Running?
They can. The deformed joint and the corns or calluses can result in pain which limits your activity.
How long will I have hammertoes? Are they permanent?
Hammertoes can get progressively worse without treatment and, without treatment, they will always be there.
Can hammertoes just go away?
Hammertoes do not just fade away without treatment. See your healthcare provider as soon as you notice the symptoms.
Living With
How do I take care of my hammertoes? Are there any at-home treatments?
Although nothing should replace the expertise of a podiatrist, you can try the following to decrease discomfort:
- Decrease pressure to the area by applying a commercial, non-medicated hammertoe pad.
- Wear shoes with a deep toebox.
- Avoid heels that are taller than two inches.
- Apply an ice pack if there’s swelling.
- Wear loose-fitting shoes.
What is it like living with hammertoes?
People with hammertoes struggle with walking and running. They get painful corns and calluses on their deformed toe.
How can I take care of my feet?
Take care of your feet by wearing shoes that are a half-inch longer than your longest toe. Avoid narrow and tight shoes, and especially high-heeled shoes.
When should I see my healthcare provider?
See your healthcare provider as soon as you notice the symptoms of hammertoes.
What questions should I ask my healthcare provider?
- Is this joint deformity a hammertoe, clawtoe, or mallet toe?
- What type of hammertoe do I have?
- What do you think caused my hammertoe?
- What kind of treatment do I need?
- Are there any at-home treatments I can try?
- Can you recommend any shoes? Or, are there shoes I should avoid?
A note from Cleveland Clinic
Don’t take your feet for granted! Take care of them. Get in contact with your healthcare provider right away if you have any symptoms of hammertoes: a joint in your toe that’s getting rigid, pain at the top of your bent toe, pain in the ball of your foot, corns or calluses on the top of your bent joint, redness or inflammation or a burning sensation in your toe, swelling and/or restricted or painful motion.
Hammertoes can get worse, and you’ll likely need treatment, so don’t hesitate to contact your healthcare provider.
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