A hammer toe is a toe that tends to remain bent at the middle joint in a claw-like position. This is potentially very painful.

There are two types of hammer toe. A flexible hammer toe has the ability to be straightened manually. A rigid hammer toe cannot be pulled straight and can be extremely painful. After time, the top of the toe may press up against the shoe, potentially causing corns or calluses (thickened skin), which are also painful. The sooner a hammer toe is treated, the more favorable the outcome. If you suspect you have this condition, contact your doctor.

Causes

Hammer toe may be congenital (present at birth) or develop later. It occurs when there is a dislocation of the middle joint of the toe due to:

• Ligaments or tendons that have tightened, causing the toe's joints to curl downward

• Pressure from an adjacent bunion

• Wearing inappropriate footwear:

• • Shoes that don't fit properly

• • High heels

• • Narrow-toed shoes

• • Shoes that a child has outgrown

• Arthritis

• The foot having a high arch

• Injury to a toe

Occasionally, all toes may be bent; this may be due to problems with the peripheral nerves or the spinal cord.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chances of developing hammer toe. If you have any of these risk factors, tell your doctor:

• Family history of hammer toe

• Arthritis

• Bunions, corns, or persistent calluses on your feet

• Frequent use of the inappropriate footwear (listed above)

Symptoms

If you experience any of these symptoms, do not assume it is due to hammer toe. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.

• A toe that buckles under

• Corns on the top of a toe

• Calluses on the sole of the foot or bottom of the toe

• Pain in the middle joint of a toe

• Discomfort on the top of a toe

• Difficulty finding any shoes that fit comfortably

• Cramping in a toe, and sometimes also the foot and leg

• Infections or ulcers in a toe

• Redness or swelling at a toe joint

• Difficult or painful motion of a toe joint

• Pain in the ball of the foot or at the base of a toe

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical examination of the toe.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Prevention

To help reduce your chances of getting hammer toe, take the following steps:

• Avoid wearing poorly fitting or narrow-toed shoes.

• Avoid heels higher than two inches.

• Check your child’s shoe size often.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

American Podiatric Medical Association
http://www.apma.org/s_apma/index.asp

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org

Nurses Entrepreneurial Foot Care Association of Canada
http://www.nefca.ca/default.asp

References:

Hammer toe. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=241&topcategory=Foot. Accessed August 26, 2005.

Hammer toe. Medline Plus. US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/0001235.htm. Accessed August 26, 2005.

Hammertoes. American Podiatric Medical Association website. Available at: http://www.apma.org/s_apma/doc.asp?TrackID=&SID=1&DID=9404&CID=371&VID=2&RTID
=0&CIDQS=&Taxonomy=False&specialSearch=False. Accessed August 26, 2005.