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When a toe involuntarily bends downward at the middle joint and looks poised to drive home a nail, you have hammertoe — and likely some pain and stiffness. The question is: Do you need surgery to fix it? Here’s how to tell.
When all of your toes line up like the keys on a piano, you can walk, jump, and tip-toe with ease. However, if any of those digits malfunctions, it affects your whole foot, gait, balance, and ability to do the most basic tasks.
Does that mean you need surgery when there’s a problem like hammertoe? Maybe, but not always.
Dr. Matthew Cerniglia at Ankle and Foot Institute of Texas in Saginaw specializes in all types of foot problems, including hammertoes, and can get you walking, jumping, and tip-toeing again soon. Here’s what he wants you to know about hammertoe and when to consider surgery.
Hammertoe: What is it, and why do I have it?
“Hammertoe” isn’t just the common name for the condition it describes; it’s also the official medical term. A hammertoe is a contracture of the proximal interphalangeal joint, but that’s an explanation, not a name.
In plain English, hammertoe is a foot deformity in which one or more of the smaller toes bend at the middle joint, resembling a hammer. It usually stems from an imbalance in the muscles, tendons, or ligaments that hold the toe straight.
Hammertoes develop for several reasons:
- Wearing shoes that squish your toes into an unnatural position, such as high heels
- Genetics — if your parents had hammertoes, you might develop them, too
- Arthritis
- Diabetes — because it can weaken foot muscles or cause nerve damage
In its early stages, hammertoe might just seem like a minor annoyance, but as it progresses, the pain becomes more severe.
When your hammertoe doesn’t need surgery
Not all hammertoes require surgery. If your toe is still flexible, meaning you can straighten it manually, there’s a good chance that conservative treatments will suffice.
One of the first steps is to change your footwear. Wear shoes with a wide toe box to give your toes plenty of wiggle room.
Dr. Cerniglia may recommend custom-designed orthotics — not over-the-counter shoe inserts — for added support and to realign your foot to relieve pressure on your hammertoe.
Physical therapy and exercises can also be highly effective. Stretching and strengthening toe exercises increase your flexibility and improve balance.
Toe splints or pads can also alleviate minor pain and prevent further bending.
These interventions are particularly effective in the early stages of hammertoe. Regular monitoring and adjustments to your footwear and daily habits might be all you need to keep your toes in check without resorting to surgery.
When your hammertoe requires surgery
Surgery may be necessary if your toe has become rigid and painful despite conservative measures or if walking and wearing shoes is intolerable.
Dr. Cerniglia typically considers surgery for a hammertoe when the toe is fixed in a bent position and when other treatments fail to provide relief. His goal with surgery is to straighten your toe, relieve pain, and improve function by realigning your bones, tendons, and ligaments.
For advice on treating a mild hammertoe conservatively or to discuss your surgical options, call Ankle and Foot Institute of Texas or request an appointment online.