Hammertoes or “Claw toes” is a deformity of the lesser toes characterized by an accordion-like contraction of toe posture that results in the “knuckles” lifted upwards and the tips of the toes pointing straight to the floor.
Symptoms of hammertoes are most commonly skin irritation and pain where the raised toe knuckles rub against shoewear. Often there are also corns, or local thickening of the skin, at the toe tips; the metatarsal heads (lesser balls of the foot); and on the raised knuckles of the toes. Corns may may become painful or ulcerated in response to persistent friction, in addition to being a nuisance with hosiery. A less perceptible yet important “symptom” of hammertoes is the loss of normal toe function in maintaining balance in standing. The deformity changes the ability of the toes to give balance to the body.
Hammertoes most frequently develop as a result of flat feet. As the arch drops, the entire foot is lengthened back to front. Toe function relies on a delicate balance of muscle control that gets disturbed as the foot lengthens abnormally. This causes the muscles that bend the toes downward to dominate and the muscles that straighten or lift the toes to be less effective. The toes then “buckle up” whenever you are on your feet. At first , the toe deformation is flexible; as the years pass and the arches drop even further, the toes begin to harden into the deformity.
Hammertoes and other non-traumatic foot deformities such as a bunion are best treated while the joints are still flexible. As with most foot problems there are two main concepts in treatment:
1) reducion of symptoms
2) addressing the underlying causes
Injections: Cortisone can be injected into the area to control inflammation and pain. This may be helpful in reducing the pain temporarily but does not address the cause of your symptoms. Overuse of injected steroids can result in side effects such as weight gain, increased blood pressure, and can interfere with proper healing; which is why patients only receive a limited number of injections.
Toe Spacers or Pads: A large variety of toe pads and spacers are available to attempt to straighten-out the toes and avoid painful rubbing in shoes. While these may help somewhat temporarily, the abnormal internal mechanics of the foot will inevitably wear out such a “band aid” approach.
Surgery: In cases where the deformity is very mature, hardened, and does not respond to conservative measures, your doctor may recommend surgery. The surgery may be very successful in reducing the pain of hammertoes but is a last resort as it comes with risks. The surgery involves the removal of the deformed joints in order to straighten the involved toes. This greatly decreases the functional capacity of those toes. Something not understood by many people is the fact that toes play an important role in maintaining balance in standing and walking. Surgical intervention brings permanent changes to foot anatomy and balance that can have negative consequences for the rest of your life.
Custom Arch Supports: The right Custom Arch Support will address your pain by correcting the cause of your foot dysfunction. Sole Supports™ Custom Arch Supports are uniquely designed to support and restore full arch functionality in your feet. This also restores the proper posture and length of the foot which normalizes the muscle balance at the toes. Toe deformities may now slowly reverse and straighten with regular Custom Arch Supports use. It is important to note that, as with most conditions, attacking the problem early enough is critical to avoid the need for surgery. Should surgery eventually be necessary, though, use of Sole Supports™ immediately after surgery can help insure that the deformity does not emerge in other toes.