Hammertoe is a bending deformity affecting one or both joints of the 2nd, 3rd, 4th or 5th toes. This irregular bending places pressure on the toe while wearing shoes which results to issues.
The condition generally starts as a mild deformity and progressively worsens over time. During the initial phases, hammertoes are flexible and the symptoms can be managed using conservative measures. If left untreated, it can become rigid and no longer respond to conservative measures.
What are the causes?
The usual cause of hammertoe is muscular to tendon imbalance. This imbalance which leads to the bending of the toe is due to mechanical or neurological alterations in the foot that arise over time in some individuals.
The condition can be worsened by wearing shoes that do not properly fit. The condition might result if the toe is too long and forced into a cramped position if a tight footwear is used.
Occasionally, the condition is due to a previous trauma. In addition, hammertoe might be inherited in some cases.
What are the indications?
The usual indications of hammertoe include:
- Irritation or pain in the affected toe when wearing shoes
- Calluses or corns on the toe, amidst 2 toes or on the ball of the foot. The corns are due to continuous friction against the shoe.
- Redness, inflammation or burning sensation
- Toe contracture
- Formation of open sores in severe cases
Management of hammertoe
There are various treatment options for hammertoe available. The treatment chosen is based on the severity of the condition and other present factors.
Some of the commonly used treatment options include:
- Padding for the corns and calluses – the doctor will provide padding that are specifically designed to protect the corns from irritation. If over-the-counter pads are used, avoid using the medicated variants.
- Modifications in the footwear used – avoid pointed toes, shoes that are too short or those with high heels. Select comfortable shoes with spacious or deep toe box and heels not higher than 2 inches
- Orthotic devices – a customized orthotic device placed within the shoe can help manage the muscle/tendon imbalance
- Medications – oral non-steroidal anti-inflammatory drugs (NSAIDs) might be given to minimize the pain and inflammation
- Injection therapy – corticosteroids might be given to reduce the pain and inflammation
- Strapping or splinting – a splint or small straps might be placed by the surgeon to realign the bent toe
When is surgery required?
In some instances where the hammertoe becomes rigid and painful or if an open sore develops, surgery is an option.
Oftentimes, those who have hammertoe along with bunions or other foot deformities should be corrected as well.