Do Hammertoes Always Require Surgery?

Hammertoes are a painful problem that affects the second, third, and fourth toes on the feet. They get their name because when the toe bends at the first joint, it points up like a hammer.

If you have a hammertoe, treatment is necessary to prevent the deformity from worsening or causing it to rub on your shoes. However, is surgery your only option for this condition?

The truth is, you have other options. The Spine and Orthopedic Center of New Mexico team provides various hammertoe treatments at our Roswell, New Mexico, office.

The facts about hammertoes

A hammertoe is a contracture of the first proximal interphalangeal joint or the closest joint to your foot. A contracture means the toe bends at that joint.

Hammertoes typically only occur in the second, third, and fourth toes. Still, the fifth toe can also be affected in some cases.

There are two forms of this condition — rigid and flexible hammertoes.

Flexible hammertoes occur first and are still treatable with conservative measures. In this stage, you can still bend the toe and move it at the first joint.

Without treatment, flexible hammertoes develop into rigid hammertoes. Once you have a rigid hammertoe, you can't move or bend the toe at the joint, causing troublesome symptoms.

Hammertoes develop due to a muscle imbalance in your toes, putting excess pressure on the tendons that control them. You're at a higher risk for hammertoes if you're living with arthritis or suffer a traumatic injury to your toe.

Genetics also play a role in hammertoe formation. If an immediate family member has hammertoes, you'll likely have one.

What symptoms signal a problem?

Hammertoes typically develop slowly over time, beginning with the flexible stage. You may feel discomfort during this stage, but the joint is still moveable.

However, as flexible hammertoes become worse, they become less mobile, leading to various uncomfortable symptoms, including:

• Pain while wearing shoes
• Swelling
• Redness
• Corn or callus formation
• Contracture of the toe
• Restricted motion

In severe cases of rigid hammertoes, an open sore may form on the bent part of the toe. In people living with diabetes, an open sore may take a long time to heal and cause a diabetic foot ulcer to form.

Is surgery my only treatment option?

When a hammertoe develops, you may wonder if you need surgery immediately. The short answer is no. Surgery isn't usually necessary if you're in the beginning stages of a hammertoe where the joint is still flexible.

However, if your hammertoe has entered the rigid stage and you can no longer move it, surgery may be recommended.

There are several types of hammertoe surgical procedures, depending on the severity of the joint problem. The forms of surgery Dr. Osmani provides include the following:

• Tendon transfer
• Tendon lengthening
• Joint resection
• Joint fusion

In severe cases, when other treatments haven't worked, and the toe is causing more harm than good, you may need an amputation to relieve symptoms. However, this is in extreme cases only where nothing else has reduced your symptoms, and other procedures haven't been successful.

Other available treatments to consider

Seeking treatment early in the formation of a hammertoe is the best option for a favorable outcome. Dr. Osmani provides several nonsurgical treatments for flexible hammertoes, which include the following:

Orthotics

Custom orthotic devices fit inside your shoes to provide your foot with personalized support. Orthotics may help take pressure off the affected joint and prevent the hammertoe from progressing.

Padding

Padding the affected joint can help prevent it from rubbing and allow you to go about your normal activities. Taping the toe helps with muscle imbalance, decreasing pain and stress on the joint.

Changing shoes

Wearing narrow high heels is no longer an option when you have a hammertoe. Choose instead comfortable, roomy shoes with plenty of space in the toe box.

Sandals are an option only if they don't put pressure on the toe joint, but a soft, spacious shoe with plenty of support is the best option.

Medications

You can take over-the-counter anti-inflammatory medications to ease inflammation and pain due to the hammertoe. Dr. Osmani also provides cortisone injections to reduce internal inflammation around the affected joint.

If hammertoes are bothering you, don't hesitate to call our office in Roswell at 575-623-9101 or book an appointment on our website.