Hammer toes affects both joints of a toe, causing the toe to bend upwards at the proximal joint (the joint closest to the foot) and down at the distal joint (the one farthest away from the foot). The resulting unnatural bend is often compared to an upside down "V" and also to a hammer or a claw (The condition is sometimes referred to as clawtoe or clawfoot). A similar condition, in which the first joint of a toe simply bends downward, is called mallet toe. Since the arched bending of hammertoe often causes the toe to rub against the top of the shoe's toe box and against the sole, painful corns and calluses develop on the toes. Hammertoe can also be a result of squeezing within a too-small or ill-fitting shoe or wearing high heels that jam your toes into a tight toe box inside your shoe, arthritis, trauma and muscle and nerve damage from diseases such as diabetes. Probably because of the tight-shoe and high-heel shoe factors, hammertoe tends to occur far more often in women than in men.
A hammer toe develops because of an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to hammertoe its contracture. Heredity and trauma can also lead to the formation of a hammer toe. Arthritis is another factor, because the balance around the toe in people with arthritis is disrupted. Wearing shoes that are too tight and cause the toes to squeeze can also cause a hammer toe to form.
A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).
Non Surgical Treatment
For hammertoes that are still flexible, a podiatrist might recommend padding or taping the toes to relieve pain and orthotic inserts for shoes to minimize pressure and keep the toe properly aligned. Anti-inflammatory drugs or corticosteroid injections can relieve pain and inflammation. For more advanced cases of hammertoe, a podiatrist might recommend a surgical procedure to cut the tendon, allowing the toe to straighten. For hammertoes that have become rigid, a more complicated surgery might be needed, during which the podiatrist removes part of the bone at the deformed joint to allow it to straighten.
If a person's toes have become very inflexible and unresponsive to non-invasive means of treatment and if open sores have developed as a result of constant friction, they may receive orthopaedic surgery to correct the deformity. The operation is quick and is commonly performed as an out-patient procedure. The doctor administers a local anesthetic into the person's foot to numb the site of the operation. The person may remain conscious as the surgeon performs the procedure. A sedative might also be administered to help calm the person if they are too anxious.