Hammertoes

While some rare cases of hammertoe are congenital, the vast majority of cases are acquired due to the following: trauma or injury to the toe, constant pressure on the toes from wearing ill-fitting shoes, arthritis, an abnormally high arch of the foot, pressure from an untreated bunion, and spinal cord or peripheral nerve damage. Your risk for developing hammertoe may also be exacerbated by the following: advanced age, heredity, a second toe that is longer than the big toe, the habitual wearing of too-tight shoes at the toes, the presence of other untreated foot disorders, and certain chronic diseases such as arthritis and diabetes. 

You can easily prevent hammertoe by wearing shoes that fit well and provide enough room for your toes to move comfortably. It is advised that you wear heels that are no higher than 2 inches, or platforms that minimize the elevation of the heels above the toes. Shoe inserts and pads that protect the toes while leaving enough room for movement can also be very helpful. Doing daily foot exercises to strengthen your toe muscles and joints can go a long way in keeping your feet healthy and pain-free. 

Though hammertoe and mallet toe are considered progressive foot conditions, it is possible to treat a mild or moderate case at home, as long as the affected toes are still flexible or in the semi-rigid stage (the hammertoe is starting to stiffen). You can try the following methods to improve your symptoms: 

 • Use over the counter hammertoe pads and inserts 

 • Wear shoes that are roomy at the toes (your toes have the space to lie flat and move around)

 • Wear shoes with heels that are 2 inches high or shorter

 • Apply an ice pack or cold compress to the affected toes

 • Wear flat, open-toed shoes or sandals with arch support

 • Do flexing and stretching toe exercises every day (but don’t force it if it causes pain)

 • Take over the counter pain relievers such as ibuprofen and paracetamol, but don’t go beyond the maximum dosage  

It is important to note that surgery is the only treatment that can correct hammertoe and mallet toe deformities. However, most patients prefer to avoid the downtime required for recovery after surgery. Surgery is only recommended after conservative treatment has failed to relieve pain and improve symptoms. 

In addition, home treatment is ill-advised if you have diabetes or a nerve disorder in the foot or leg. Because these conditions put you at a higher risk of health complications, we urge you to see your doctor right away if you suspect any problems with your foot. 

There are no set rules for determining the seriousness of your foot condition, but you should see your healthcare provider or podiatrist right away if:

 • The joint in the affected toe is getting stiffer and less flexible

 • The pain has not improved or continues to worsen

 • You are developing other foot issues related to your hammertoe such as corns, calluses, and ulcerations

 • Your foot condition is interfering with your ability to complete important daily responsibilities

 • You have diabetes, a nerve disorder in the foot or leg, or rheumatoid arthritis

Because hammertoe is a progressive foot disorder, it will not improve on its own without treatment and targeted lifestyle changes. Mild to moderate cases of hammertoe can be successfully controlled and even improved with dedicated home treatment and conscientious habits, but more severe cases can only be corrected through medical intervention. Those who have certain ailments such as diabetes or arthritis need to seek immediate treatment to avoid potentially serious health problems.

While hammertoe and mallet toe are nothing to stress over in their mild or moderate form, they can lead to debilitating health issues if left untreated. Potential complications include:

 • Permanent stiffness and immobility of the affected toe 

 • Permanent foot disfigurement

 • Corns, calluses, blisters, and ulcerations on the hammertoe

 • Increasing pain and inflammation in the affected foot

 • Infection of blisters and ulcers 

 • Gangrene (in extreme cases, especially for diabetic patients)

Potential treatments include custom or prescription orthotic inserts and devices, cortisone injections to the affected toe to relieve pain and inflammation, and surgery. Surgery is only recommended after non-invasive therapies have been tried without success. 

Your surgeon may employ one or a combination of the following techniques to correct your hammertoe:

 • Fusing the affected toe joints to straighten out the toe

 • Cutting the ligament or tendon that is curling the affected toe

 • Repositioning and straightening the tendon of the affected toe

The length of recovery time will vary between 3 weeks to 3 months, but most patients usually need about 6 weeks. Fortunately, today’s surgical procedures are minimally invasive, leading to significantly decreased downtime and a lower risk of complications. 

While everyone is going to be different in their healing time due to a variety of factors, there are some basic recommendations that anyone can follow to accelerate rehabilitation after surgery:

 • Stop smoking (nicotine can slow down blood flow and slow the healing of your cells)

 • Keep weight off the treated foot until indicated otherwise by your doctor

 • Wear the surgical shoe for the indicated time and follow recommendations on proper footwear during recovery

 • When sitting, elevate your foot to the level of your heart for the first few weeks after surgery

 • Keep your bandages clean and dry, and cover them with a plastic bag while bathing if necessary

 • Follow foot exercise instructions to strengthen your toe muscles and restore flexibility

Sensible lifestyle changes play an important role in preventing the recurrence of your hammertoe after recovery has been completed. Good habits such as wearing comfortable shoes, avoiding or reducing activities that could potentially injure your feet, and doing daily foot exercises can go a long way in ensuring the health of your feet for years to come.