Hammertoe Treatments That Bring Relief

What You Need to Know

Understanding hammertoe, its causes, and how we treat it at every stage.

Understanding Hammertoe and Your Options

Hammertoe is a deformity where one or both joints of the second, third, fourth, or fifth toes begin to bend outside of their normal alignment. The bent toe looks like an upside-down “V.” This abnormal imbalance of muscles increases the pressure on the toe’s joints and tendons, and over time the toe can become more deformed to the point of causing severe pain with regular daily activities.

Hammertoes may be flexible or rigid, depending on the joint’s ability to move. A flexible hammertoe is still moveable and can often be straightened with your fingers. Although they look painful, flexible hammertoes may not hurt. Rigid hammertoes are more serious and may require surgical treatment. This type can develop in people who have severe arthritis or those who wait too long to seek treatment for a flexible hammertoe.

The most noticeable symptom is an abnormal bend in the toe. Other signs include pain at the top of the toe from shoe pressure, corns on top of the bend, swelling and redness of the joint, restricted motion, and pain extending to the ball of the foot. Friction from shoes may also lead to corns or calluses between your toes.

The most common cause is a muscle or tendon imbalance, which results from mechanical or neurological changes in the foot. Genetics, injury, arthritis, diabetes, bunions, and tight or high-heeled shoes can all contribute. Because hammertoes are progressive and never get better without intervention, we recommend seeing a podiatrist as soon as symptoms start so we can examine your foot, take X-rays, and build a treatment plan suited to your needs.

Treatment, Recovery, and Prevention

If your hammertoe is still flexible, non-surgical treatments are often effective. These include padding and taping to shield the toe and minimize pain, switching to shoes with a deep, wide toe box, custom orthotics to control the muscle and tendon imbalance, corticosteroid injections or oral NSAIDs to reduce pain and inflammation, splinting or strapping to realign the bent toe, and physical therapy to strengthen the foot and correct imbalances.

When a hammertoe has become rigid and painful, or when an open sore has developed, surgery may be needed. Options include tendon transfer for toes that are still somewhat flexible, joint resection to allow the toe to fully extend, and arthrodesis or joint fusion, where the ends of the two bones that form the affected joint are cut and held in place with pins or screws while they heal. Many patients also have bunions or other deformities corrected at the same time.

Almost all hammertoe surgeries are outpatient procedures. Your foot will be bandaged after surgery, and you may need to wear a surgical shoe for several weeks. Elevation and ice help limit swelling. Raise your foot above heart level and apply ice for 15 to 20 minutes, placing a towel between the ice pack and your skin.

You can help prevent hammertoes from forming or worsening by wearing supportive shoes with a wide toe box, avoiding high heels, and having your feet remeasured as you age. Custom orthotics and gentle toe stretches also help maintain flexibility. With the right care, even severe hammertoes can usually be treated so you can move more easily again.