Hammer Toe

Overview

What is hammer toe?

When a person has hammer toe, the end of their toe bends downward and the middle joint curls up. Eventually, the toe gets stuck in a stiff, claw-like position. When the inside of your shoe rubs against a hammer toe, corns, blisters or calluses may form on top of the toe or on the bottom of your foot. This can make walking painful. You may also have pain in the joint where your big toe joins your foot.

Hammer toe usually affects a person’s second toe (the toe next to the big toe), but it can affect other toes too.

Causes

What causes hammer toe?

People who are born with long bones in their toes are more likely to develop hammer toe. Children who wear shoes they have outgrown may develop this condition. People who wear very narrow shoes or high-heeled shoes are also more likely to develop a hammer toe.

Sometimes, pressure from a bunion can cause hammer toe. Rheumatoid arthritis is another a risk factor.

Prevention

How can I prevent hammer toe?

Avoid wearing shoes that are narrow or don’t fit well. Also, don’t wear heels higher than 2 inches. Instead, choose shoes with a wide toe box that give you ½ inch between the end of your longest toe and the inside tip of the shoe.

Check often to make sure your child’s shoes fit, especially when he or she is having a growth spurt.

Treatment

How is hammer toe treated?

If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective footwear, corn pads and other devices to reduce pain.

You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best.

If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.

Will I need surgery for hammer toe?

If you have a severe case of hammer toe or if the affected toe is no longer flexible, you may need surgery to straighten your toe joint. Surgery requires only a local anesthetic (numbing medicine for the affected area) and is usually an outpatient procedure. This means you don’t have to stay in the hospital for the surgery.

Questions to Ask Your Doctor

  • What is the likely cause of my hammer toe?
  • How do I know that my or my child’s shoes fit correctly?
  • What is the best treatment option for me? Will I need surgery?
  • How long before I can expect relief from my symptoms?
  • Is it possible that my symptoms could return, even after treatment?
  • Is it safe for me to exercise? What kind of shoes should I wear?