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Hammer Toe

By Kendrick Alan Whitney, DPM, Department of Biomechanics, Temple University School of Podiatric Medicine

Hammer toe is a toe that is bent in a fixed Z-shaped position.

  • Pain may be felt when people wear certain shoes, and some people have pain in the ball of the foot.

  • Diagnosis is based on an examination of the foot, and other joints are examined as well.

  • Wide shoes and toe pads can relieve irritation, and orthoses can relieve pain.

Among the causes of hammer toe are unusually long metatarsal or toe bones, poor foot posture, rheumatoid arthritis, and years of wearing ill-fitting shoes. Because part of the toe is higher than normal, excessive friction may result, leading to corns and possibly open sores (ulcers) on the top of the toe. The second toe is the most common toe to develop hammer toe deformity.

Wearing shoes, particularly shoes with low and narrow toe boxes, may be painful. Sometimes people develop pain in the ball of the foot (metatarsalgia).

What Is Hammer Toe?

In hammer toe, usually the second toe, or sometimes the third or fourth toe, becomes bent in a Z-shaped position and cannot be easily straightened without surgery.

Diagnosis

  • A doctor's examination

Doctors base the diagnosis of hammer toe on an examination of the foot. Doctors also examine the joints to look for arthritis.

Treatment

  • Wide toe box and toe pads

  • For metatarsalgia, orthoses

Doctors treat hammer toe by ensuring that the shoes are comfortable and have a wide enough toe box to avoid further irritation to the toe. Toe pads sold in pharmacies also help by shielding the affected toes from the overlying shoe.

Any ulcer or other skin irritation is treated.

An operation to straighten the hammer toe may be needed when other treatments do not relieve the pain and disability caused by the rigidly fixed toe.

To alleviate the pain caused by metatarsalgia, people can use orthoses (devices placed in the shoe).

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* This is the Consumer Version. *