For an early stage hammertoe, when the toes are flexible to move, simple treatment options can help treat the condition, such as:
- Customized footwear
- Stretching exercises
- Non-medicated corn pads
However, when the condition is severe, only surgical methods are recommended.
What is a hammertoe?
Hammertoe is a condition when the muscles and ligaments around the toe joint get out of balance. The end of the toe bends downward, and the middle portion curls upward.
Hammertoe mostly affects the middle three toes.
3 types of hammertoes
- Flexible hammertoes: Mild and early-stage hammertoes that can be easily moved. At this stage, there are several treatment options.
- Semi-rigid hammertoes: The toes start to get stiff.
- Rigid hammertoes: The tendons of the toes get rigid and make the toe joint out of alignment. It presents with difficulty moving the toe. At this stage, you may require surgery.
What causes hammertoe?
Improper muscle balance can increase the pressure on the tendons and joints, resulting in hammertoes.
The following are the causes of muscle imbalance:
- Genetics: Plays a role in the development of hammertoe. This depends on the type of foot you have. People with flat flexible feet and high arches try to stabilize against the flattening arch, which results in a hammertoe.
- Unsupportive shoes: Too narrow, ill-fitting, or high heel shoes have little arch support. High heel shoes put lots of pressure on the toes and the joints, resulting in hammertoes. Hammertoes are more common in women than in men.
- Neuromuscular disease: People with diabetes have several complications, such as diabetic neuropathy. In some people with corn or a diabetic foot ulcer, excess pressure on the toes results in hammertoes. The infected corns sometimes lead to loss of toe or foot, and shoe modification can help get better from the condition.
- Trauma: Rarely any trauma to the toe can result in a hammertoe.
What are the symptoms of hammertoe?
The main symptoms of hammertoe are the end of the toe bending downward and the middle of the toe joint curling upward.
Other symptoms include:
How to diagnose and treat hammertoe
Your healthcare provider will perform a general and physical examination and ask for the symptoms. Your doctor will confirm the diagnosis by the physical appearance of the toe and check the toe's movement. If required, your doctor may advise for X-rays.
Here are some treatment options to relieve symptoms of hammertoes:
- Change in footwear: The doctor may recommend avoiding wearing tight, narrow, and high-heeled footwear. The footwear should be at least half an inch longer than the longest toe. Some shoes contain a soft, roomy toe box or deep toe box where the hammertoe can be accommodated comfortably, reducing the pressure on the toe. Wearing sandals may help reduce the symptoms.
- Exercises: Gentle stretching exercises may help. Another exercise is picking up things with the toes. Usually, this exercise is done using a towel. It is placed on the floor and curled using the toes.
- Medications: Over-the-counter pain medications alleviate pain and swelling.
- Non-medicated corn pads: Relieve pain and other symptoms of hammertoes.
- Ice application on the toes: Helps relieve swelling and pain in the toes.
Surgical procedures are recommended in the severe form of hammertoe, where the toes become very stiff and cannot move.
The following surgical procedures are usually done:
- Arthroplasty: The surgeon removes part of the joint under the bent region of the toes, so it lies flat.
- Arthrodesis: The whole joint under the crooked toes is removed and wire is inserted to make it straight as it heals.
- Tendon transfer: The surgeon attaches tendons from the bottom of the crooked toe to the top of the toe, which helps straighten the toe.
- Basal phalangectomy: A surgeon removes the base of the bone below the hammertoe and helps straighten the toe.
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