Hammertoes - Small Changes with Big Consequences

Hammertoes start small but in the wrong patient can have big consequences.

Hammertoe is a contracture (bending) of one or both joints of any toes besides the big toe. This abnormal bending can put pressure on the toe when wearing shoes. This causes pain, calluses, blisters, or even ulcers to develop.

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.

In the case of a patient with numbness or poor circulation to the foot a hammertoe can be a covert source of a bad infection. Too many times we see patients that never look at the bottom of their toes and are surprised when we find a bad infection setting in that they never knew was there.

Non-surgical Treatment:

  • Padding corns and calluses.  Over the counter medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Your foot and ankle specialist can give you some great pads if you cant find the non-medicated type. This treatment does nothing to correct the problem, it just delays skin breakdown.
  • Changes in shoe gear.  Choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
  • Orthotic devices.   A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Controlling the imbalance early enough may help halt the progression of hammertoes.
  • Splinting/strapping.   Splints or small straps may be applied by the surgeon to realign the bent toe.

In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed. If you have a hammertoe and are having issues, consider making an appointment to visit Dr. Gary Friedlander or Dr. Jay Larson at Sole Foot and Ankle Specialists in Glendale, Arizona to have your feet evaluated.

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