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Hammer Toe Pain

by Jaydee Vykoukal, PT, DPT January 21, 2021 0 Comments

Hammer toes, similar to mallet toes, arise from an imbalance in the toe’s soft tissues. Hammer toe can cause pain and swelling, and may contribute to the development of blisters and calluses. Luckily, there are many ways to treat hammer toe at home. Read on to learn more.

What is Hammer Toe?

A hammer toe is a deformity or abnormal bend in the middle joint of the toe. The mechanisms of development are similar to mallet toe, except it occurs in the joint nearest the toenail. 

Which Toes Develop Hammer Toe?

The second, third, and fourth toes are most commonly affected by hammer toes with big toes less commonly affected. 

How Does Hammer Toe Happen?

This toe deformity happens when certain muscles, ligaments, or tendons in the toe become tight and out of balance. This causes the toe to take on an abnormal, crooked appearance as the joint lifts upward and creates an upside down “V” with the entire toe.

Can You Reverse Hammer Toe?

In mild to moderate cases, the toe remains flexible. You may be able to straighten it if you press down on the affected joint. But severe or untreated hammer toes can become rigid. At this stage, you will be unable to move the joint out of its crooked position. 

Precautions that Help Prevent Hammer Toes

Claw Toe vs. Hammer Toe

In the case of a claw toe, the middle toe joint digs down into the sole of the shoe while the last joint closest to the toe nail lifts upward. Essentially, these two joints move in the opposite extremes when compared to hammer toe. Over time, the toe becomes rigid and may become permanently deformed. It can also cause calluses to develop on the toe and other areas of the foot.

Learn more about claw toe, mallet toe, and curly toe in our post on crooked toe conditions.

What Causes Hammer Toe?

Hammer toe occurs when the soft tissues in the toe become too tight or get injured. Several factors contribute to the development of hammer toe, including injury, your choice of shoes, and the structure of your feet.

The most common hammer toe causes are:

Tight Shoes

Ill-fitting shoes that have a tight toe box, such as high heels or pointed flats, crowd the toes. Crowded toes are unable to lie flat, increasing the risk that the joint will become bent out of shape. Continuously wearing tight shoes will cause the toes to curl even in bare feet.

Injury

If you jam or stub your toes, you are at increased risk of hammer toe. That’s because the injury can damage the tissues at the joint and throw them out of alignment. People who have previously broken a toe are also at risk of hammer toe, even after the fracture heals.

Muscle Imbalance

An abnormal balance in the toe muscles causes instability in the toe. One of the most common issues is overactive toe extensors (that bring the toes up). It puts you at greater risk of hammer toe and other types of foot and toe injuries.

Risk Factors of Hammer Toe

Although anyone can develop hammer toe, the following factors significantly increase your risk of the condition:

  • Older adults are more likely than younger people to get hammer toe and other crooked toe conditions. This is because the muscles in the body, including the feet, can weaken and lose flexibility with age.
  • Women are more likely than men to develop a hammer toe because they tend to wear shoes with tighter toe boxes.
  • Toe length. The risk of a hammer toe increases if your second toe is longer than your big toe. Heredity may play a role in toe length.
  • Having other illnesses. People with arthritis, diabetes, and other conditions that affect the feet are more likely to develop toe deformities.

Hammer Toe Symptoms

The most common symptom of a hammer toe is a bend in the middle joint of one of your toes, typically the middle three toes. In the early stages, you will likely be able to temporarily straighten the toe by pressing on the bend. Unless you seek treatment and address the underlying causes, eventually the toe will most likely become rigid, even if you press it.

Other symptoms of hammer toe include:

  • Pain or inflammation around the crooked joint
  • Poor circulation
  • Increase in pain when wearing shoes, especially tight shoes or high heels
  • Difficulty moving the affected toe
  • Redness at the injured joint
  • Stiff or rigid middle toe joints
  • Blisters or calluses on the toes or other areas of the feet

Ways to Treat Hammer Toe Symptoms

Diagnosis

Typically, a podiatrist or doctor can diagnose hammer toe by carrying out a visual inspection. They may press down on the toe to see how rigid the joint is and to check for your pain response. The doctor may also inspect other areas of the foot for blisters, bunions, and calluses.

To rule out other conditions, such as a fracture, your doctor may order a hammer toe X-ray of your foot to check the bones and joints.

Outlook

Most people with a hammer toe deformity can manage their symptoms through home remedies, lifestyle changes, and medications. However, if you do not attempt any form of hammer toe correction, the condition will get worse over time. Eventually, your toe will feature a permanent bend and become painful and irritating. It will also increase your risk of other toe and foot injuries.

For the best chance of recovery, seek early treatment and be diligent about looking after your feet.

How to Prevent Hammer Toe

As always, prevention is better than the cure. To prevent hammer toe from developing in the first instance, try the following:

  • Choose well-fitting shoes, that provide adequate toe support and allow for the full length of your toes and a wide toe box without compression
  • Maintain a healthy weight to avoid putting excess pressure on the feet and toes.
  • Use toe separators and spacers after running or other activities that strain the feet.
  • Go barefoot or wear open-toe shoes when possible.
  • Wear shoe inserts to evenly distribute pressure throughout the foot.
  • Talk to a physical therapist for biomechanical recommendations to boost your foot health and lower body alignment

More on Preventing Hammer Toes

Dealing with Hammer Toes

Don’t suffer in silence with foot pain caused by hammer toe. See your doctor or a podiatrist who can provide you with an accurate diagnosis and a treatment plan. In addition to medical treatments, you can try home remedies and lifestyle changes for toe deformities. Some of the best options include hammer toe orthotics such as inserts, splints, sleeves, and spacers. Exercises are also important to relieve pain and reverse crooked toes.

Finally, don’t forget to choose the right shoes. Wearing good-quality and well-fitting footwear prevents and alleviates hammer toe, along with many other common foot problems.

Sources:

https://www.medicalnewstoday.com/articles/315600#:~:text=A%20hammer%20toe%20is%20a,are%20flexible%20to%20begin%20with.

https://www.mayoclinic.org/diseases-conditions/hammertoe-and-mallet-toe/symptoms-causes/syc-20350839

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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