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Hammer Toe - Causes, Symptoms, Treatment, Pictures

Updated on March 24, 2014

Hammer toe refers to a deformity of the foot that usually affects women who wear shoes with high heels or a narrow toe box. These kinds of footwear often force the toes against the front part of the shoe resulting in an abnormal bend.

A hammer toe is identified by an atypical bend in the middle joint of the second, third, and fourth toes. However, it generally affects the toe that is next to the big toe.

The pressure and pain associated with hammer toe can be alleviated by wearing shoe inserts and changing the type of footwear used. Severe instances of hammer toe may need to be corrected via surgery.

Symptoms of hammer toe

Some of the signs and symptoms of hammer toe are listed below:

  • The affected toe may appear bent like a claw or a hammer
  • Irritation by shoes can result in pain
  • Difficulties and pain in movement of the affected toe
  • Constant rubbing of the hammer toe against the shoe can make it hard and coarse, or increase the risk to development of corns and calluses
  • Patients may also experience problems in walking
  • The affected toe may become deformed
  • Hammer toe can also increase the risk to developing ulcers and toenail fungus infections
  • Swelling, redness, and inflammation around the joints
  • The toe joints may become stiff
  • If all the four toes experience impairment, or in chronic and untreated cases of hammer toe, patients may experience tightening and contraction of the tendons that eventually leads to tendons dysfunction, permanent stiffness of the affected toe, and cramping of the foot, toes, and leg.
  • Severe cases of hammer can cause a sinking pressure on the foot leading to development of corns and coarse skin on the soles.

Causes of hammer toe

Hammer toe has been associated with the following:

  • Use of specific shoes: Footwear that is excessively tight in the toe box, or those with high heels can jam the toes into an area that is not spacey enough for them to lay flat. Such a curved position of the toe may persist even when one is barefoot.
  • Nerve diseases or injuries: People with nerve damage in the feet are more likely to suffer from hammer toe. It may also be noted that nerve damage usually occurs along with medical disorders such as diabetes or stroke.
  • Trauma: Any kind of injury caused by jamming, stubbing, or breaking of a toe increases the risk of that specific digit to form hammer toe.

Some of the risk factors which increase the vulnerability to developing hammer toe are listed below:

  • Older people are at greater risk to developing hammer toe than younger individuals.
  • A second toe that is longer than the big toe is at greater risk to hammer toe
  • Women are more likely to develop a hammer toe than men

Diagnosis and treatment of hammer toe

A physical examination of the affected toe is sufficient to diagnose a case of hammer toe. Doctors may also suggest x-rays for further evaluation of the joints and bones in the toes and feet.

  • Patients with a still flexible hammer toe will be advised by doctors to change over to a more comfortable and roomier footwear along with the use of orthotics or shoe pads or inserts. Wearing pads can help reposition the affected toe and alleviate the pain and pressure.
  • Use of correct footwear can relieve the foot pain. Wearing shoes with low heels, a deep toe box, and supple material that cover the toes also help. It is important to ensure that there is about half an inch of space between the inside shoe tip and the longest toe. Allowing for enough toe space will help in alleviation of pain and pressure associated with hammer toe.
  • Doctors may also recommend certain exercises that help strengthen and stretch the toe muscles, such as picking up a towel or marbles from the floor by using the toes.
  • The use of OTC corn-removal products should be avoided as a lot of them have acid which can cause intense skin irritation. Also, avoid cutting off an ugly corn or shaving the toe. Wounds on the foot can get easily infected and they are usually difficult to treat, particularly in diabetics and patients with poor circulation.
  • In case traditional treatments fail to yield results, then the doctor may suggest surgery to free the tendon which is not allowing the toe from lying flat. Occasionally, doctors may also take out some bone pieces to unbend the hammer toe.

People can follow the below listed tips when buying shoes, thereby decreasing the risk to hammer toe and other foot problems:

  • Go for low heeled shoes. They also help prevent back anomalies
  • Footwear with pointed toes should be avoided as they do not allow enough toe room
  • Laced footwear are adjustable and thus roomier.
  • Buy shoes at the end of the day as the feet tend to swell up during the day

Always check the shoe size. It can change with an increase in age, especially the foot width.

Hammer Toe Pictures


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