Foot Conditions
Hammertoes
Description
What is a Hammertoe?
A hammertoe is a contracture—or bending—of
the toe at the first joint of the digit, called the proximal interphalangeal
joint. This bending causes the toe to appear like an upside-down V
when looked at from the side. Any toe can be involved, but the condition
usually affects the second through fifth toes, known as the lesser
digits. Hammertoes are more common to females than males.
There are two different types:
Flexible Hammertoes:
These are
less serious because they can be diagnosed and treated while still
in the developmental stage. They are called flexible hammertoes because
they are still moveable at the joint.
Rigid Hammertoes:
This variety is more developed and more serious than
the flexible condition. Rigid hammertoes can be seen in patients with
severe arthritis, for example, or in patients who wait too long to
seek professional treatment. The tendons in a rigid hammertoe have
become tight, and the joint misaligned and immobile, making surgery
the usual course of treatment.
Symptoms
-
Pain upon pressure at the top of the bent toe
from footwear.
-
The 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.
How Do You Get a Hammertoe?
A hammertoe is formed due an abnormal balance of the
muscles in the toes. This abnormal balance causes increased pressures
on the tendons and joints of the toe, leading to its contracture.
Heredity and trauma can also lead to the formation of a hammertoe.
Arthritis is another factor, because the balance around the toe in
people with arthritis is so disrupted that a hammertoe may develop.
Wearing shoes that are too tight and cause the toes to squeeze can
also be a cause for a hammertoe to form.
What Can You Do
for Relief?
-
Apply a commercial, nonmedicated hammertoe pad
around the bony prominence of the hammertoe. This will decrease
pressure on the area.
-
Wear a shoe with a deep toe box.
-
If the hammertoe becomes inflamed and painful,
apply ice packs several times a day to reduce swelling.
-
Avoid heels more than two inches tall.
-
A loose-fitting pair of shoes can also help protect
the foot while reducing pressure on the affected toe, making walking
a little easier until a visit to your podiatrist can be arranged.
It is important to remember that, while this treatment will make
the hammertoe feel better, it does not cure the condition. A trip
to the podiatric physician’s office will be necessary to
repair the toe to allow for normal foot function.
-
Avoid wearing shoes that are too tight or narrow.
Children should have their shoes properly fitted on a regular
basis, as their feet can often outgrow their shoes rapidly.
-
See your podiatric physician if pain persists.
What Will Your
Podiatrist Do to
Treat a Hammertoe?
The treatment options vary with the type and severity
of each hammer- toe, although identifying the deformity early in its
development is important to avoid surgery. Podiatric medical attention
should be sought at the first indication of pain and discomfort because,
if left untreated, hammertoes tend to become rigid, making a nonsurgical
treatment less of an option.
Your podiatric physician will examine and X-ray the affected area
and recommend a treatment plan specific to your condition.
Padding and Taping:
Often this is the first step in a treatment plan. Padding the hammertoe
prominence minimizes pain and allows the patient to continue a normal,
active life. Taping may change the imbalance around the toes and thus
relieve the stress and pain.
Medication:
Anti-inflammatory drugs and cortisone injections can
be prescribed to ease acute pain and inflammation caused by the joint
deformity.
Orthotic Devices:
Custom shoe inserts made by your podiatrist may be
useful in controlling foot function. An orthotic device may reduce
symptoms and prevent the worsening of the hammertoe deformity.
Surgical Options:
Several surgical procedures are available to the podiatric
physician. For less severe deformities, the surgery will remove the
bony prominence and restore normal alignment of the toe joint, thus
relieving pain.
Severe hammertoes, which are not fully reducible, may require more
complex surgical procedures.
Recuperation takes time, and some swelling and discomfort are common
for several weeks following surgery. Any pain, however, is easily
managed with medications prescribed by your podiatric physician.
Your Feet Aren’t Supposed
to Hurt
Remember that foot pain is not normal. Healthy, pain-free
feet are a key to your independence and need regular attention. At
the first sign of pain, or any noticeable changes in your feet, seek
professional podiatric medical care. Your feet must last a lifetime,
and most Americans log an amazing 75,000 miles on their feet by the
time they reach age 50. Regular foot care can make sure your feet
are up to the task. With proper detection, intervention, and care,
most foot and ankle problems can be lessened or prevented. Remember
that the advice provided in this pamphlet should not be used as a
substitute for a consultation or evaluation by a podiatric physician.
Information Provided by the American Podiatric Medical Association
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