What is a hammer toe?

 Hammer toe is a term used to describe a type of foot deformity. It typically occurs in women who use high-heeled or narrow toe box shoes. Such footwear generally push the toes towards the front area of the shoe, consequently causing an anomalous curve/bend.

The presence of an abnormal curve in the middle joint of the 2nd, 3rd, and 4th toes can be termed as hammer toe. It however usually occurs on the toe near the big toe.

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The pain and pressure that accompanies hammer toe can be released by changing the type of shoes currently used and using shoe inserts. Surgery may be required to correct extreme cases of hammer toe.

Symptoms of hammer toe

A few common signs and symptoms of hammer toe are as follows:

  • The deformed toe may seem as if it is bent like a hammer or a claw.
  • Pain in the affected foot; problems in moving it.
  • Irritation by footwear can cause pain.
  • The affected toe may become coarse and thick due to constant friction against the footwear. It also poses increased vulnerability to formation of calluses or corns.
  • Deformity of the hammer toe.
  • Affected people may experience difficulties in walking.
  • An increased risk to development of fungal infections in the affected toenail, as well as hammer toe ulcers.
  • Increased stiffness of the toe joints.
  • Redness, inflammation, and swelling of the area surrounding the joints.
  • Extreme instances of hammer toe can result in a sinking pressure in the affected foot. This can hasten the formation of coarse skin and corns on the soles.
  • In untreated and persistent instances of hammer toe, or during impairment of all the 4 toes, affected people may elicit constriction and tightening of the tendons. This can lead to permanent toe stiffness, tendons impairment, and chronic cramps in the leg, foot, and toes.

Causes of hammer toe

The below listed factors can cause the development of hammer toe:

  • Trauma: Any injury arising due to bumping, squeezing, or breaking of a toe increases the risk of that particular toe to developing hammer toe.
  • Nerve injuries or conditions: Individuals with an underlying case of nerve damage in any one or both feet are at greater risk to developing hammer toe. Nerve damage typically accompanies conditions like stroke or diabetes.
  • Wearing a particular type of shoes: Use of footwear with high heels or a constricted toe box can cram the foot and the toes into a small space which prevents it from lying flat. Such an abnormal bent position of the affected toe may continue even when the patient is barefoot.

Listed below are certain risk factors which can pose increased threat to formation of hammer toe:

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  • Women are at a greater risk to suffering from hammer toe as compared to men
  • Presence of a longer second toe in comparison to the big toe.
  • Older persons are more susceptible to hammer toe than younger people.

Treatment of hammer toe

  • Hammer toe associated foot pain can be eased by wearing correct type of shoes. Patients should change over to shoes with a deeper toe box, low-set heels, and softer material that enclose the toes. Patients need to make sure that around ½ inch of space is present between the longest toe and the inside section of the shoe end. The presence of adequate toe room will help find relief from the pressure and pain.
  • In cases where the hammer toe still retains some flexibility, doctors will recommend the use of a more spacey and comfortable footwear. They may also suggest using orthotics, or shoe inserts or pads. The use of pads can aid in repositioning of the abnormal toe and alleviation of pressure and pain.
  • Avoid using non-prescription products to remove corns as they can result in severe skin irritation. Also do not shave the affected toe or manually cut out an ugly corn. Foot wounds are very vulnerable to infections and often take a long time to heal, especially in diabetics and people with poor circulation.
  • The doctor may also suggest some exercises to help stretch and toughen the muscles of the toe. For example, picking up marbles or a towel lying on the floor by using just the toes.
  • If the normal treatment options do not work, then the physician may recommend surgery to release the tendon that is preventing the toe from being flat. On occasions, the surgeon may also remove some bone pieces to correct the bent hammer toe.

Follow the tips given below when buying shoes. It will help reduce the susceptibility to developing hammer toe and other foot anomalies.

  • Shoes with low-set heels are not only good for the feet, but also for the back.
  • Shoes with laces can be adjusted for space and hence recommended.
  • Avoid shoes with tapering ends as they constrict the available space.
  • Always verify your shoe size when buying new ones. Shoe size, particularly the foot-width, can change as one grows older.
  • Purchase footwear in the evening, because the feet swell up during the course of a day and are at their largest in the evening.
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