Colorado Orthopedic News

Hammer Toe

Hammer Toe

A hammer toe is so named because the affected toe resembles a hammer when the joint is stuck in an upright position. Initially, hammer toes are flexible and can be corrected with simple measures, but if left untreated, they can be fixed and require surgery. This deformity can cause pain and difficulty walking and progressively worsen with time. That is why the moment you notice something wrong with your toe, you should immediately see one of the experienced orthopedic specialists at Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado. Don’t wait until it’s too late.

OVERVIEW

A hammer toe is a deformity of the second, third, or fourth toes. In rare cases, all of the toes are affected. The toe bends at the middle joint so that it bends down and resembles a hammer. When the joint goes rigid, it becomes stuck and can cause not only pain but also corns and calluses. A hammer toe is more likely to occur in women who wear shoes that do not fit well or often wear shoes with high heels. It can even occur in children who wear shoes they have outgrown. Hammer toes are common, affecting approximately 3% of all adults over age 21 in the United States alone. They are not purely a cosmetic issue—they can be painful and cause many other problems.

ABOUT THE TOES

Most people have 26 bones in each foot. Fourteen of the 26 bones are found in the toes. Each toe has three bones, except the big toe, which has two. The toes are made of several structures found throughout the rest of the body—bones, nerves, arteries, veins, tendons, and muscles. The bones of the toes, like those of the fingers, are called phalanges.  The toes provide multiple functions when they work properly. They support the body’s weight and, along with other structures of the feet, provide shock-absorbing properties when running, walking, or jumping. In addition, the toes also provide balance when walking and provide the final push-through during a stride. In addition, the toes contain nerves that send many signals to the brain, including signals of pain when they are injured.

WHAT IS A HAMMER TOE?

“Hammer toe“ is a term for progressive symptoms and joint changes that involve one or more of the toes. A hammer toe deformity happens because muscles in the foot or leg get weak, and the tendons to the toe pull abnormally. There are three types of hammer toes:

  • Flexible hammer toes: a flexible hammer toe is still developing, so the affected toes can still move at the joint.
  • Semi-rigid: the hammer toe is starting to stiffen.
  • Rigid hammer toes:  a rigid hammer toe can no longer move because the tendon and soft tissues have tightened.

CAUSES

The most common cause of hammer toe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from structural or neurological changes in the foot that occur over time. Other causes include:

  • An unusually high foot arch
  • Longer toes
  • Wearing shoes that don’t fit properly
  • Pressure from a bunion, which is when the big toe points inward toward the second toe
  • Genetics
  • Age and gender
  • Past injury
  • Other health conditions, such as diabetes and arthritis

SYMPTOMS

Symptoms of hammer toe include:

  • A joint in the toe that’s getting rigid
  • One toe consistently in a bent position
  • Pain—usually at the top of the bent toe
  • Pain in the ball of the foot
  • Blisters, corns, and calluses at the top of the joint
  • Redness, inflammation, or a burning sensation
  • Restricted or painful motion of the toe joint
  • Pain walking

NON-SURGICAL TREATMENTS

In the early stages of hammer toe, the toe is still flexible. During this time, non-surgical approaches can stop the toe from becoming stuck in a bent position. These include:

  • Footwear changes: flat or low-heeled shoes with a heel of fewer than 2 inches, shoes with a wide and deep toe box, open-toe shoes or sandals
  • Exercises: exercises may strengthen and stretch the muscles in the feet, which may reduce the imbalance causing hammer toe.
  • Over-the-counter products: foot aids to hold toes in a comfortable position to reduce pressure on them include insoles, cushioned straps, tubes, or cushions.
  • Anti-inflammatory drugs or cortisone injections can alleviate pain
  • Custom inserts or orthotic devices can control how the foot functions

WHEN IS SURGERY INDICATED?

A doctor may recommend surgery if the pain is severe, the hammer toe interrupts daily activities, or non-surgical treatments haven’t helped. If one is unable to flex the toe, surgery is the only option to restore movement. Surgery can reposition the toe, remove deformed or injured bone, and realign tendons and joints. Surgery is normally done on an outpatient basis.

GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.

Although hammertoes are readily apparent, to arrive at a diagnosis, your foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take X-rays to determine the degree of the deformities and assess any changes that may have occurred. At Advanced Orthopedics in Denver, Parker, and Aurora, Colorado, your foot surgeon will explain everything they are doing and answer any questions you might have. If surgery is recommended, they will discuss the different surgery options, explaining which they believe is right for you. At Advanced Orthopedics, they’ll do everything to get you back on your feet, free to go anywhere without pain. Schedule an appointment with one of our foot specialists today.

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