Hammer toes are a painful deformity of your second, third or fourth toes. The condition causes your toe or several toes to contract upwards and become permanently bent at the middle joint. The end of your toe or toes flexes downward and creates a shape that vaguely resembles a hammer.
Hammer toes are caused by imbalances in the strength of your lower leg and foot muscles. Your muscles work in pairs to straighten and bend your toes. If your toe is bent and held in the same position over a period of time then your muscles tighten and become unable to stretch out.
Ill-fitting and high-heeled shoes are thought to play a part in the development of hammer toes as they can push your lesser toes into a bent position that eventually results in your toe muscles becoming unable to straighten your toe, even when there is no confining shoe.
Arthritis, injury and bunions are also thought to cause hammer toes. Narrow or high-heeled shoes can also cause your toes rub against your shoe and this may lead to corns or calluses forming, which further aggravate the condition.
Problems associated with hammer toes
Sometimes hammer toes are just a cosmetic problem, but more often they are associated with pain caused by problems associated with having hammer toes including:
- Corns or calluses on the top of your toe, or in between your toes that rub on your shoes.
- Calluses under the ball of your foot.
- Pain in the ball of your foot, called metatarsalgia.
- Arthritis or rheumatoid arthritis pain in the joints of your toe.
- Bunion often exists with hammer toes.
If you have hammer shoes you also have the added problem of finding comfortable fitting shoes.
Treatment options of hammer toes
Hammer toes that are just starting to develop tend to be flexible and can be manually pulled straight and may improve with exercises that counteracts your muscle imbalance such as those that pull your foot upwards against resistance. However, the longer you have hammer toes the more likely it is they will be rigid, or non-reducible.
Changing your footwear may improve your hammer toes. It’s advisable to choose shoes that are soft and have a high and broad toe box to accommodate your hammer toes and reduce friction against them. You should avoid wearing tight, narrow, high-heeled shoes.
Other conservative treatments include using hammer toe crests and hammer toe splints to help hold down your hammer toe. Protective pads may be recommended to relieve symptoms of hammer toes and shoe friction, and include gel toe shields, gel toe caps, cushions and nonmedicated corn pads to relieve symptoms.
A podiatrist may assess your hammer toes and recommend custom-made orthotic arch supports and heel wedges to help counteract the imbalances that lead to hammer toes.
The only way to correct hammer toes is with surgery. It is usually recommended if non-conservative measures have not relieved your symptoms or you are experiencing secondary problems, such as skin wounds.
Usually, surgery is carried out on an outpatient basis under local anaesthetic. The exact procedure will be based on the type and extent of your deformity.
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