Hammertoes are quite common and may range from mild to severe. A hammertoe is a contracture, or bending, of one or more toes, usually due to an imbalance between the muscles or tendons on the top and bottom of the toes. Over time, the affected toes lose flexibility, becoming rigid and fixed in a contracted position. The abnormal bend positions the knuckle of the toe upward, causing it to push against the top of the shoe leading to additional problems. The condition usually becomes progressively worse if not treated.
Many people develop hammertoe because they wear shoes that are too tight. Shoes with narrow toe boxes squeeze the toes together, forcing some to bend. This causes the toe muscles to contract. If the toes are forced into this cramped position too often, the muscles may permanently tighten, preventing the toes from extending. Chronic hammertoe can also cause the long bones that connect the toes to the foot, called metatarsals, to move out of position. The misaligned metatarsal bones may pinch a nerve running between them, which can cause a type of nerve irritation called a neuroma.
At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you’re not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff. Your shoes can rub against the raised portion of the toe or toes, causing painful corns or calluses.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery. Podiatric medical attention should be sought at the first indication of pain and discomfort because, if left untreated, hammertoes tend to become rigid, making a nonsurgical treatment less of an option. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to Hammer toe your condition.
If conservative measures fail to provide relief, or if your hammertoe is in advanced stages with rigidity and a significant amount of pain, surgery may be required. Some patients also require surgery if they have open sores or wounds related to their hammertoe. For patients who also suffer from bunions, a combined procedure may be appropriate, addressing both conditions within the same surgery. Recovery time will vary from patient to patient, depending on the extent of the surgical repair and other conditions that may also be present.
Preventing foot problems, including hammertoes, is often a matter of wearing the right shoes and taking care of your feet. Check your feet regularly for problems. This is especially true if you have diabetes or any other medical condition that causes poor circulation or numbness in your toes. If you do, check feet daily so that problems can be caught early on.