Hammertoes

What are hammertoes?

Hammertoes are changes in your toe joints that make them point up instead of lying flat. They’re one of the most common foot issues.

Having hammertoes makes your affected toes look like they’re bent all the time. Specifically, a hammertoe happens when the tip of your toe points down and the middle curls up. Hammertoes usually develop in the second joint of your lesser toes (not your big toe).

A mild hammertoe may not affect your ability to walk or use your foot, but if it’s not treated, it can get bad enough to freeze your toe in its curled shape. Severe cases can make your toes look like they’re stuck in an upside-down V shape. Some people think affected toes have a hammer shape, which is where hammertoes get their name.

Visit a podiatrist if you notice any changes in your feet or toes, especially if you’re experiencing symptoms like pain, stiffness or trouble walking. They’ll suggest treatments to manage your symptoms, fix the hammertoe and help your toes return to their usual shape.

Types of hammertoes

Podiatrists group hammertoes into three different types based on their severity:

• Flexible hammertoes: You can still bend and move your affected toes, but a noticeable curl or hammertoe is starting to form.
• Semi-rigid hammertoes: Your affected toes are noticeably stiff or hard to uncurl.
• Rigid hammertoes: The most advanced hammertoes are frozen in the curled position. You won’t be able to uncurl your toes at all. Rigid hammertoes are more likely to require surgery.

How common are hammertoes?

Hammertoes are common. Experts estimate that hammertoes are up to 20% of all foot and ankle issues.

What are hammertoe symptoms?

You can usually see a hammertoe. You’ll probably be able to notice one or more of your toes looking more curled than usual — especially compared to your other toes.

Other hammertoe symptoms can include:

• Pain (usually at the top of your affected toes or the ball of your foot).
• Trouble moving your affected toes.
• Corns and calluses forming on top of your affected toes.
• Swelling.
• Skin discoloration.

What causes hammertoes?

Hammertoes happen when something pushes your toes out of position for a long time. Eventually, the muscles and tendons in your feet and toes adjust to the unusual, cramped position and tighten up. If that extra pressure lasts long enough, your muscles and tendons may tighten so much you can’t move your toes out of the curled position.

The main causes of hammertoes include:

• Wearing poorly-fitting shoes: Shoes that are too narrow (have a small toe box) or don’t have enough arch support can force your toes into unnatural positions. People who wear high heels and kids who keep wearing shoes they’ve outgrown may develop hammertoes.
• Having high arch feet or flat feet: Your foot’s natural shape may make you more likely to develop hammertoes.
• Having long toes: If your toes are naturally longer than usual, they may not have enough room in common shoe widths or sizes. This can put extra pressure on them and cause hammertoes.
• Certain health conditions: Any condition that affects your feet and toes can cause hammertoes. People with diabetes or rheumatoid arthritis may have an increased risk.
• Bunions: Bunions can push your toes out of alignment and put extra pressure on them.

How do healthcare providers diagnose hammertoes?

A podiatrist will diagnose hammertoes with a physical exam of your foot and toes. They’ll examine your toes and joints. They’ll touch and move your toes to see how your joints move. Tell your podiatrist which types of shoes you wear most often, and if you notice that some kinds of footwear make symptoms like pain better or worse. Your podiatrist may ask you to stand or walk with or without your shoes on.

You may need a foot X-ray to take pictures of your foot and toe bones.

What are hammertoe treatments?

Your podiatrist will suggest treatments to relieve the pressure on your affected toes and give them room to return to their natural position, including:

• Footwear changes: Switching to shoes with wide, deep toe boxes can take pressure off your toes. You may be able to use a stretching device to widen shoes you already own.
• Pads and taping: Over-the-counter (OTC) toe pads cushion the area around your toes to relieve pressure. Your provider might suggest using medical tape to hold your toes in the correct position.
• Orthotic devices: Orthotics are shoe inserts that support your feet and keep your toes in the correct position. You might need over-the-counter orthotics or custom-made inserts. Your provider might suggest placing a spacer between your affected toes, too.
• Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and swelling. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
• Toe exercises: Your podiatrist may suggest exercises or stretches that will help your toes stay in the correct alignment.
• Surgery: Your podiatrist will usually only recommend surgery if other treatments don’t relieve your symptoms or walking is extremely painful. Your provider or surgeon will tell you which type of surgery you’ll need and what to expect.

What happens if you don’t treat hammertoes?

Untreated hammertoes may become severe enough to affect your balance or how you walk (your gait). These more severe symptoms are rare, and should get better once a podiatrist diagnoses and treats the hammertoes.

How can you prevent hammertoes?

Wearing, comfortable, well-fitting shoes is the best way to prevent hammertoes. In general, follow these tips to find comfortable shoes that fit your feet properly:

• Avoid shoes with narrow, pointed tips — especially if they fit tightly on your toes.
• Even if you know your size, try on a few pairs of shoes to make sure you’re getting the best fit. Labeled shoe sizes aren’t always the same between brands and styles.
• Sit, stand and walk in new shoes before buying them. Make sure no movement or position hurts, pinches or pushes on your toes.
• Trying shoes on at the end of the day may give you a more accurate fit (your feet naturally swell slightly over the course of a day and are bigger later in the day than first thing in the morning).

Can a hammertoe be straightened?

Yes, most cases of hammertoes respond well to treatment. It might take several weeks after starting treatment to see any changes in your affected toes. But stick with it. Straightening a hammertoe takes time and patience. Talk to your podiatrist if it feels like your symptoms are getting worse or you’re not seeing any improvements after a few weeks.

How can I straighten my hammertoe naturally?

The term “natural” doesn’t have a set medical definition, but most people with hammertoes can treat them without surgery. Remember, there’s nothing “unnatural” about needing surgery to treat any medical condition, including hammertoes. The best treatment for you is the one that works and gets you back to your usual routine.

Will a hammertoe go away on its own?

Most hammertoes won’t go away on their own. It’s possible that flexible or semi-rigid hammertoes will straighten out without treatment. For example, if you notice a hammertoe developing and change the kinds of shoes you wear right away, your toes may uncurl with no other treatment.

But don’t leave your foot health to chance. Visit a podiatrist or healthcare provider if you think you might have a hammertoe. A medical professional should diagnose and treat any changes in your feet, especially if you’re experiencing symptoms like pain or stiffness.

What questions should I ask my provider?

You may want to ask your healthcare provider:

• What’s causing the hammertoe?
• Which treatments will I need?
• When would you recommend surgery?
• Which types of shoes are best for my feet?

What’s the difference between claw toes, hammertoes and mallet toes?

All three are different conditions that affect your toes and can make them bend up. The difference is which toe joints they affect:

• Hammertoes: Bend in the second (middle) toe joint.
• Mallet toes: Bend in the third toe joint, closest to your toenail.
• Claw toes: Bends in all three toe joints.

Visit a podiatrist as soon as you notice any changes in your feet, including pain and stiffness in your joints.