Hammer toe is defined as a deformity in the toe where part of the toe is permanently bent downward resembling a hammer. Two related conditions are mallet toe and claw toe which effect different toe joints in slightly different ways. The key difference is that Hammertoe tends to effect the middle joint in the toe (note: not the middle toe, the middle toe joint). The disease is usually associated with the second largest toe but can effect the third or fourth toe as well. Mallet toe effects the uppermost toe joint whereas claw toe is caused by the tow being held in a cramped ?claw-like? position.
Wearing ill-fitting shoes is probably the main cause of hammer toe. As the toe bends, tendons add to the problem by contracting in such a way that the bending is reinforced to the point of becoming permanent. In some cases, tendons that are abnormal to begin with may start the bending process.
The symptoms of a hammer toe include the following. Pain at the top of the bent toe upon pressure from footwear. Formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).
Non Surgical Treatment
In the early stages, the deformities from mallet toe, claw toe and hammertoe can be corrected. But if treatment is delayed too long, permanent stiffness can ensue which can only be corrected by surgery. The most effective treatment options are good fitting footwear. Shoes with a wide toebox will be more comfortable and will reduce the tension on the muscles and friction on the toes. Avoid high heels as they push your feet forwards to the front of the shoes. This increases the pressure on the toes, forcing them to bend more than usual. Shoes should ideally be half an inch longer than your longest toe. Exercises to strengthen and stretch the muscles can be really helpful. Simple things like trying to pick marbles up with your feet or scrunching up a towel underneath your foot can work well.
If these treatments are not sufficient at correcting the hammer toe, an operation to straighten the toe may be necessary. This is often performed in conjunction with surgery for a bunion deformity. The surgical treatment of a hammer toe can consist of either cutting the tendons to relieve the pressure that causes the deformity, or fusing the toe so that it points straight permanently.