Hammer toe is caused by an inherited muscle imbalance or abnormal bone length. It may occur in children who outgrow their shoes rapidly. In this condition one or more small toes buckle when the middle joint (the PIP joint) contracts. This causes the tendons to shorten.
A foot with a bunion will often have a hammer toe also. Over time, the bunion slants the big toe toward and then under the second toe, the most frequently 'hammered' toe. This forces the second toe to rise into a claw-like position.
A hammer toe can lead to severe pain and pressure. Like claw toe, it creates extra stress in the ball of the foot, often leading to the development of corns and calluses.
The main cause of hammer toe is wearing tight shoes that crowd the toes, or high heels. It may also be brought on by an injury.
The cause of the condition is a tightening of the ligaments and tendons of the toe, causing a buckling of the joint of the toe. The result is a cocking of the toe upward, whereas in a normal foot, the toes lie flat. Shoes can then rub on the top of the cocked toe, eventually causing painful corns or calluses. If the deformity is not treated, the toe may become permanently fixed and rigid.
A hammer toe may also develop because of:
Besides pain and its claw-like appearance, symptoms of hammer toe include:
Treatment for hammer toe can be as simple as having the corn that has developed on the toe trimmed by a doctor to relieve pain and swelling. If a bunion is present, that condition may require specific treatment. Other recommendations may include:
If the hammer toe has become is rigidly fixed in an inflexible position, surgery may be required. The goal of hammer toe surgery is to realign the toe and improve function or to lengthen the tendons by removing part of the proximal phalanx in older patients. Procedures may include:
If surgery is required, a period of several weeks in an open-toed surgical shoe that acts like a hammer toe splint will probably be needed.
Any change to one part of the foot significantly affects habitual ways of walking and standing. Left untreated, foot ailments such as claw toe, hammer toe, or mallet toe may produce problems in other weight-bearing joints, such as the hips or knees.
Any forefoot problems causing pain or discomfort should be given prompt attention. People who experience problems with their feet should seek advice from an experienced physician or podiatrist who can evaluate the risks, benefits, and possible complications of various treatment options. Patient compliance is particularly important in the treatment of these conditions.
Ignoring the symptoms of deformities of the toes can aggravate these conditions and lead to a breakdown of tissue, or even infection. Conservative treatment starts with accommodating the deformity. The goal is to relieve pressure, reduce friction, and transfer force from the sensitive areas. If surgery is recommended, it is important to fully understand and follow the recommendations of the surgeon before and after the procedure.
The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.
