8 Things to Know About Hammer Toe

  • Unseen person's foot in tub with hammertoe and bunion
    What to Know About Hammer Toe Deformity
    A hammer toe is a deformity of a joint or multiple joints in the second, third or fourth toe of your foot. It affects more women than men because the condition is often caused by wearing shoes that put too much pressure on the toes, such as high heels or shoes with pointy toe boxes. The toes are forced into an unnatural position, sticking up at the joint rather than flexing downward. The most commonly affected toe joint is the ‘middle’ joint, or the proximal interphalangeal (PIP) joint. 

    Hammer toes cause pain or difficulty walking, and it can be hard to find shoes that fit properly. Get smart with information on hammer toe heredity, treatment and prevention.

  • Top view of unseen parent and child's feet in ocean surf on beach
    1. Hammer toes can run in families.
    Some people develop hammer toes even if they’ve never worn tight shoes or high heels. The condition can run in families, particularly if you have flat feet. As your feet try to compensate for having no arch, your toes try to stabilize your foot, which is not a natural position for them. This can cause uneven muscle and tendon forces (tissues that allow you to flex and extend your toes), eventually causing your toe(s) to move into a hammer toe position. People with certain neuromuscular diseases are also at risk of developing hammer toes.

  • Senior man on running path holding foot and ankle in pain
    2. Hammer toes can be painful.
    As your toe begins to move and bend in an unnatural direction, it can cause pain, particularly when you are wearing shoes that don’t allow your toes to wiggle. As your foot changes shape because of the toe, the skin over the toes and under the ball of the foot can develop corns or calluses, or you can develop blisters. The contracture of the toe can also be painful. If you can still move your toe, this is flexible hammer toe. If you can’t move it, this is rigid hammer toe, which is more serious. See a podiatrist for an accurate diagnosis of hammer toe.

  • Cropped image of unseen woman in black heels rubbing foot in pain
    3. Nonsurgical hammer toe treatment can be a pair of new shoes.
    You may know of people who have had hammer toe surgery, but usually the first treatment steps include trying nonsurgical therapies. The first thing to do is to change your shoes if you still wear high heels or shoes with pointed toes. Your toes must be able to move freely without pressure on the ends of your toes or the ball of your foot, and your heels should be no higher than two inches. When shopping for shoes, including athletic shoes, wiggle your toes and see how much space you have. Some shoes have smaller toe boxes than others and it may not be noticeable until you try to move your toes.

  • Close-up of corn removal pad on toe
    4. Over-the-counter products may help reduce pain.
    If you have developed corns or calluses on your foot because of the hammer toe, there are over-the-counter (OTC) products that shield and protect the skin. A podiatrist or foot and ankle surgeon may recommend a specific type for you, and may warn you against using OTC pads that have medications in them. These may seem like a good idea to help manage the rough or raised skin areas, but they can be harmful for some people, especially people who have diabetes. There are also special orthotic devices you can wear in your shoe that push your toes in a more natural position.

  • Close-up of person's foot holding pencil between big toe and second toe
    5. Don’t laugh—hammer toe exercises are a thing.
    Exercising your toes to move in the direction they are meant to helps strengthen the muscles and encourages the toes to lie naturally. The main exercise is to curl your toes and then spread them out, and then wiggle them. The best way to curl them is to try to pick things up, like a pencil, or to scrunch up a cloth under your toes, and then pick it up with your foot. This exercise also helps keep your toe joints flexible.

  • Unseen patient about to receive foot injection from unseen doctor
    6. You can usually manage the pain and stiffness with medications or injections.
    If OTC and orthopedic products aren’t helping you, your doctor may recommend an injection with a corticosteroid. Injecting the medicine directly into the affected toe may help relieve inflammation and allow you to move your toe more easily. Moving the toe, in turn, activates the underused muscles and tendons. OTC or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) may also be helpful in relieving inflammation and pain. Some people get relief from applying ice to the toe, but be sure not to put ice directly on the skin—wrap the ice to prevent damaging the skin from the cold.

  • Unseen man with large black cast on lower leg in hospital room with walker
    7. Surgery is a last resort for hammer toe.
    Hammer toe surgery is generally only performed if all other therapies have failed and you continue to have serious pain or your foot is severely deformed. One approach is to remove any bony prominences from the toe and then align the toe properly. If the deformity is caused by a tendon pulling too tightly, your surgeon may either release the tendon by cutting it, or replace it with a tendon taken from another part of your body. A pin in the joint may be necessary to keep it straight. The pin, known as a K-wire, is usually temporary. Permanently fusing the joint is another possible option.

  • Unseen young woman slipping on comfortable white sneakers
    8. You can reduce the risk of hammer toe recurring.
    If you’ve been able to manage your hammer toe at home or you have had surgery, keep in mind the problem can worsen or return if you wear tight shoes or high heels again. Treat your feet well by ensuring they have the right type of shoe and that you don’t put too much pressure on your toes again. Your feet will thank you!

8 Things to Know About Hammer Toe | Hammer Toe Surgery & Treatment

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
  1. Hammertoe. American College of Foot and Ankle Surgeons. https://www.foothealthfacts.org/conditions/hammertoe
  2. Hammertoe and mallet toe. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hammertoe-and-mallet-toe/symptoms-causes/syc-20350839
  3. Hammertoe. FamilyDoctor.org. https://familydoctor.org/condition/hammer-toe/
  4. Best Ways You Can Treat, Prevent Hammertoe. Cleveland Clinic. https://health.clevelandclinic.org/best-ways-you-can-treat-prevent-hammertoe/
  5. Ellington JK. Hammertoes and clawtoes: proximal interphalangeal joint correction. Foot Ankle Clin. 2011 Dec;16(4):547-58. doi: 10.1016/j.fcl.2011.08.010. https://www.ncbi.nlm.nih.gov/pubmed/22118228
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 4
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