Hammertoes Need Attention!

Hammertoe is a contracture (bending) deformity of one or both joints of the second, third, fourth, or fifth toes. This abnormal bending can cause pressure to be put on the toe when you are wearing shoes. This causes problems to develop! Hammertoes can start out mild, but over time will get worse. If hammertoes are treated early on, the toes are much more flexible and the symptoms can often be managed with non-invasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

Causes

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from structural or neurological changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that do not fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.

Symptoms- Common symptoms of hammertoes include:

• Pain or irritation of the affected toe when wearing shoes.
• Corns and calluses (a buildup of skin) on the toe, between two toes or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending on their location.
• Inflammation, redness, or a burning sensation
• Contracture of the toe
• In more severe cases of hammertoe, open sores may form.

Diagnosis

Dr. Kylin Kovac at Idaho Foot & Ankle Center will do a thorough history and examination of the foot. He may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, Dr. Kovac may take x-rays to determine the degree of the deformities and assess any changes that may have occurred. Hammertoes are progressive—they do not go away by themselves and usually they will get worse over time. However, not all cases are alike—some hammertoes progress more rapidly than others. After Dr. Kovac has examined you, he can develop a treatment plan that will be suited to your needs.

Nonsurgical Treatment

There is a variety of treatment options for hammertoe. The treatment plan will depend on the severity of your hammertoe and other factors.

• Padding for corns and calluses : Dr. Kovac can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult Dr. Kovac about this option.
• Footwear changes: Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels—conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toebox and heels no higher than two inches.
• Orthotics: A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.
• Injection therapy: Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
• Medications: Oral non-steroidal anti-inflammatory drugs such as Ibuprofen may be recommended to reduce pain and inflammation.
• Splinting/strapping: Splints or small straps may be applied by Dr. Kovac to realign the bent toe.

When is Surgery Needed?

In some cases, usually when the hammertoe has become more rigid and painful or when an open sore has developed, surgery is needed. Often, patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, Dr. Kovac will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

If you have any questions about your foot health or symptoms that you are experiencing, please don’t hesitate to contact Dr. Kylin Kovac at Idaho Foot & Ankle Center 208-529-8393 or schedule an appointment online.

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