What Is It?

The smallest four toes of each foot have three bony segments connected by two joints, just as the fingers do. Hammertoe is a deformity in which one or more of the small toes develops a bend at the joint between the first and second segments so that the tip of the toe turns downward, making it look like a hammer or claw. The second toe is affected most often.

Most hammertoes are caused by wearing of ill-fitting, tight or high-heeled shoes over a long time. Shoes that don't fit well can crowd the toes, putting pressure on the middle toes and causing them to curl downward. Hammertoe also can be caused by a bunion, which is the knobby bump that sometimes develops at the side of the big toe. A bunion causes the big toe to bend toward the other toes. The big toe can then overlap and crowd the smaller toes. Occasionally, a hammertoe is inherited or caused by arthritis in the toe joint.

If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons shorten enough that the toe stays bent, even when shoes are not being worn.

Symptoms

The symptoms of hammertoe include:

• A curling toe

• Pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward

• Thickening of the skin above or below the affected toe with the formation of corns or calluses

• Difficulty finding shoes that fit well

In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.