Overview
The Hammer toe condition is usually irreversible, but often its progression can be slowed or halted. You should visit a Podiatrist if the toe becomes painful and you have difficulty walking. A Podiatrist will be able to provide advice and treatment including padding hammertoes the bony top-part of your hammertoe to relieve pain or to tape your toes as a way to change their position. Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.
Causes
Hammer toe may also be caused by other medical conditions such as rheumatoid arthritis, osteoarthritis, or stroke because these forms of illnesses involve affectation of the person’s muscles and nerves. Diabetes is also a causative factor for hammer toes due to diabetic neuropathy, which often times accompanies advanced instances of diabetes. Injury to a person’s toes may also cause hammer toes, particularly if the injury involves breaking of the toes. In some instances, hammer toes may be hereditary. Some people may be genetically predisposed to develop the condition because of the natural structure of their bodies.
Symptoms
If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons shorten enough that the toe stays bent, even when shoes are not being worn. The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward, thickening of the skin above or below the affected toe with the formation of corns or calluses, difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.
Diagnosis
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include Soaking your feet every day in warm water, then stretching your toes and ankles by pointing your toes. Using over-the-counter pads, cushions or straps to decrease discomfort. Splinting the toe to keep it straight and to stretch the tendons of the foot. Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises). One simple exercise is to place a small towel on the floor and then pick it up using only your toes. You also can grasp at carpet with your toes or curl your toes up and down repeatedly. Wearing shoes that fit properly and give toes plenty of room to stretch out.
Surgical Treatment
Surgical correction is needed to bring the toe into a corrected position and increase its function. Correction of the hammer toes is a simple outpatient surgery, with limited downtime. The best option is to fuse the deformed and contracted toe into a straight position. This limits the need for future surgery and deformity return. A new pin that absorbs in the bone or small screw is used by the Foot and Ankle Institute to avoid the need for a metal pin protruding from the toe during recovery. Although the absorbable pin is not for everyone, it is much more comfortable than the pin protruding from the end of the toe. In certain cases, a removal of a small area of bone in the deformity area will decrease pain and limit the need for a surgical waiting period that is found with fusions. Although the toe is not as stable as with a fusion, in certain cases, an arthroplasty is the best option.
Prevention
You can avoid many foot, heel and ankle problems with shoes that fit properly. See your doctor if you have foot pain that’s persistent and that affects your ability to walk properly and carry out other motions with your foot. Also, see your doctor if one or more of your toes has developed a clenched or claw-like appearance.
Lashanda Weissinger 