Hammer toes are defined as the bending of the first joint at the base of the toe. This joint is called the proximal interphalangeal joint. The bending of the toe looks something like an upside-down letter “V” from a side view-point. Hammer toes can affect any toe, but most commonly affect the second toe (next to your big toe), third toe, fourth and fifth. These toes are known to be lesser digits.
Did you know that hammer toes are more prevalent amongst women? There are two types of hammer toes- known as flexible or rigid.
They are less serious, and are diagnosed and treated while in their developmental stage. They are still moveable at the proximal interphalangeal joint.
They are more developed and serious. These types are often seen in patients with severe arthritis or those who wait too long to seek professional treatment. Tendons in a rigid hammer toe are tights, as the joint becomes misaligned and immobile. Surgery is usually the treatment in these cases.
There are commercially made, non-medicated hammer toe pads which can be put around the bone prominence of the toe. These decrease some of the pressure you may feel in that area.
Another option is choosing supportive and comfortable shoe gear, such as shoes with a deep toe box.
If swelling or redness persists, using ice packs several times a day can reduce swelling.
It is important to avoid heels more than two inches tall. A loose fitting pair of shoes can protect and reduce pressure on the hammer toe(s), making walking easier. You want to avoid wearing shoes that are too narrow or tight.
It is important to remember that while these treatments will make the hammer toe(s) feel better, they will not cure the condition. A trip to the podiatry office will be necessary to repair the toe and allow normal foot function.
If you are experiencing pain consistently, it is time to visit a podiatrist. Untreated hammer toes can become rigid, making more conservative treatment less of an option.
The treatment options of hammer toes depends on the type and severity of the condition. Identifying a hammer toe early in its development is an important factor in avoiding surgery. The podiatrist will examine and x-ray the area. Based on their findings, they will recommend a treatment plan.
Padding and taping of the hammer toe are often the first steps in the treatment plan. Padding the hammer toe prominence minimizes the pain and can allow a patient to continue their normal, active lifestyle. Taping can be used to adjust the imbalance of the area around the toes and relieve stress and pain associated with it.
In some cases, medication can be prescribed to ease pain and inflammation. Anti-inflammatory drugs and cortisone injected are seen to reduce discomfort and acute pain. A great recommendation that can be useful in treatment are orthotic devices. Custom shoe inserts will reduce symptoms and prevent further development of the hammer toe deformity.
Surgical treatment, as mentioned above, is an option for severe deformity. For the less severe deformities, the surgeon can remove the bony prominence of the deformity and restore alignment of the toe joint. This surgical treatment relieves pain. Severe hammer toes (rigid), which are non-reducible, can require even more complex surgical procedures.
There are many things you can do to prevent hammer toes from developing. Wearing supportive shoe gear can prevent deformities. Hammering of toes is often the result of faulty foot mechanics, especially flat footedness. Custom orthotics can slow the progression of the deformity and prevent further development of hammer toes. Avoiding shoes with narrow or pointed toe boxes compress the toes and often lead to this type of deformity.