Hammertoe is a foot deformity that occurs when one or more of the small toes bend permanently at the joint. The condition affects the second, third and fourth toes, but not the pinky toe, because it has only one joint. There are several different treatment strategies for hammertoe, depending on how advanced it is.
If the hammertoe is still flexible enough to be manually straightened, non-surgical treatment methods may help improve flexibility in the toe tendons and relieve pain and discomfort. Doctors recommend avoiding foot surgery whenever possible, especially if you have diabetes or other health problems or are an athlete. If your hammertoe can no longer be straightened, however, you will need hammer toe surgery. Learn more about the procedures to choose the best one for you.
Non-Surgical Treatments for Hammertoe
As hammertoe progresses, the tendons in the toe become tighter and tighter, until the joint stiffens completely and the toe can no longer be straightened. Before that happens, though, non-surgical therapies may help the toe maintain some flexibility and can relieve the pain that occurs when bent toes rub against your shoes.
If you have hammertoes, you should wear roomy shoes with wide, boxy toes, supportive arches and low heels. Roomy toe boxes provide plenty of space to keep the hammertoes from rubbing, and low heels don’t force the toes forward, jamming them against the front of your shoe the way high heels do. You may also want to wear custom-made shoes or orthotic inserts.
Toe pads and splints can hold your toe in a straightened position. You may also tape your toes to gently force them into a straightened position. While these treatments can’t correct hammertoe, they can keep your toes from rubbing painfully against your shoes and may prevent your toes from becoming completely stiff. You should also do exercises to keep your toes flexible and improve strength in the toe muscles. You can relieve pain in your feet with over-the-counter pain relievers.
To stretch your toes, gently straighten them with your fingers. If you have more than one hammertoe, work on one at a time. You should feel a stretch in your toe as you gently pull it straight, but it shouldn’t hurt. Stretch each hammertoe several times morning and night. To strengthen your toes, spread a towel on the floor and use your toes to crumple it. Also, try picking up small objects, like marbles, from the floor using only your toes.
Surgical Treatments for Hammertoe
If your hammertoe has progressed to the point that your toes will no longer straighten at all or if non-surgical treatments have failed to relieve your pain, you will need surgery. There are several procedures used to treat hammertoe, including:
- Metatarsal shortening. This procedure is used to correct hammertoe that occurs when an unusually long second toe becomes constricted by your shoe. The procedure gives your toe more room to straighten out in your shoe.
- Tendon release. In this procedure, surgeons cut your toe tendons and may also trim some of the tissue around the affected joint, allowing the toe to relax.
- Resection. To perform this procedure, the surgeon removes a portion of bone from the joint, allowing the toe to straighten.
- Arthrodesis. This procedure involves fusing the toe joint so it can no longer curl. This doesn’t affect the function of your toe much.
- Tendon transfer. This involves re-routing a tendon in the toe, which can pull it straight.
- Implants. A newer procedure allows surgeons to insert a tiny implant into the joint of your hammertoes, holding them straight permanently. Implants eliminate the possibility that hammertoe can return.
Many hammertoe surgeries require the surgeon to insert long, thin wires into the toe to hold it straight. The wires must be removed after six to eight weeks, during which time the patient must take it easy and stay off his or her feet. Even then, hammertoe may return unless the joint is fused. Implants are the surgery of choice because they allow patients to walk immediately and hold the toe straight permanently.
Should You See a Podiatrist?
Hammertoe symptoms may not be obvious in the beginning stages of the disease. If you begin to experience pain in the balls of your feet or front of your leg, especially when you stretch your toes downward, or you notice that the skin on top of your toes is thickening or your toes are curling, see a podiatrist right away. With early intervention, you may be able to avoid hammertoe altogether.
Hammertoe is a painful deformity of the toes that can require surgery to correct. If you have hammertoe it’s important to see a doctor to rule out the possibility of underlying causes. Treatment can relieve your pain and keep this condition from becoming crippling.
