The muscles of each toe work together to keep the toe straight. When the toe muscles get out of balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on the toe’s tendons and joints. The more powerful tendon pulls and forces the toe to bend. Tapered shoes may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces pressure toward the tip of the toebox and squishes the toes against the shoe, increasing the pressure and the bend in the toe.
Initially, hammertoes are flexible and can be corrected with simple measures but, if left untreated, they can become rigid and require surgery.
Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. Keep in mind that this could be either your big toe or your second toe. Avoid wearing tight, narrow, high-heeled shoes. Don’t wear heels higher than 2 inches. Wear the appropriate shoe for the activity you are doing. You can buy non-medicated hammertoe pads. They fit around the pointy top of the toe joint and help relieve painful pressure. Gently massaging the toe may help relieve pain.
Drugs that reduce inflammation can ease the pain and swelling. Sometimes a doctor will use cortisone injections to relieve acute pain. A podiatrist may also custom-make an insert to wear inside your shoe. This can reduce pain and keep the hammertoe from getting worse.
Hammertoe can be corrected by surgery if conservative measures fail. There are several surgical techniques used to treat hammertoes. Often these can be done in the doctor’s office without the need for hospitalization.
When the problem is less severe, the doctor will remove a small piece of bone at the involved joint and realign the toe joint. More severe hammertoes may mean more complicated surgery.