Diseases Treatment

What is this Condition?

In hammer toe, the big toe becomes crooked at the joint where it lines up with the other toes. The end of the bone is enlarged and a bunion (inflamed, thickened toe joint tissues) forms where it rubs the shoes. Hammer toe can cause a callus on the sole of the foot and make walking painful.

What Causes it?

Hammer toe may be inherited, but it more often develops in people with degenerative arthritis or in those who place prolonged pressure on the foot, especially from narrow-toed high-heels. That’s why hammer toe is more common in women. The condition also can develop in children who rapidly outgrow shoes and socks.

In congenital hammer toe, abnormal alignment of the bones (increased space between joints) causes bunion formation. In acquired hammer toe, the bone alignment is normal before the disorder occurs.

What are its Symptoms?

Hammer toe usually begins as a tender bunion covered by deformed, hard skin and a bump that feels distended with fluid. The first indication of hammer toe may be pain over the bunion from shoe pressure. The pain could come from injury-caused arthritis, bursitis, or abnormal stresses on the foot because hammer toe changes the way a person walks. In an advanced stage, the foot may appear flat and spread out, with severely curled toes and a small bunion on the fifth toe.

How is it Diagnosed?

A red, tender bunion makes hammer toe obvious. X-rays confirm the diagnosis by showing a crookedness of the big toe.

How is it Treated?

Depending on the severity, hammer toe may require the following treatment:

• In children (and some adults), repeated foot manipulation and splinting may relieve pain and correct hammer toe.

• If the disease progresses to severe deformity with disabling pain, the person may need surgery to remove the bunion. After surgery, the toe is immobilized in its corrected position with either a soft dressing or a short cast.

• After surgery, the person may need crutches for 4 to 6 weeks, or may simply learn to walk on his or her heels for a few days. The individual may be taught about physical therapy, such as applying warm compresses and soaks and doing exercises, as well as using drugs to relieve pain and stiffness.

What can a Person with Hammer toe do?

In the very early stages of acquired hammer toe, good foot care and proper shoes may eliminate the need for further treatment.

A person can use felt pads to protect the bunion, foam pads or other devices to separate the first and second toes at night, and a supportive pad and exercises to strengthen the arch. Early treatment is vital if other foot problems caused by rheumatoid arthritis or diabetes are present.