A hammertoe is a deformity of the middle joint of a toe, producing a clenched, clawlike appearance in the affected digit. The tendons in the toe become abnormally contracted, causing the toe to bend downward, which, in turn, forces the joint to protrude upward.
A mallet toe is a deformity in which the end joint of a toe becomes bent downward, so that the toe curls underneath itself. In either case the affected joints are stiff, and often the toe cannot be straightened out.
Constant rubbing against shoes may furthermore cause a painful corn (a round patch of rough, thickened, calloused skin) to develop over the joint or at the tip of the affected toe. Hammer and mallet toes may occur in any toe, although the second toe is the most common site. These deformities are often painful and limit the toe’s range of motion—sometimes requiring surgery.
What Causes Hammertoe and Mallet Toe?
- Wearing shoes that are too short or that have pointed toes may produce hammer toe.
- Long-term diabetes mellitus commonly causes nerve damage in the feet and so may lead to hammertoe.
- The cause of mallet toe is unknown.
Symptoms of Hammertoe and Mallet Toe
- A toe (usually the second digit, next to the big toe) bent at the middle joint and clenched into a painful, clawlike position. As the toe points downward, the middle joint may protrude upward.
- A toe with an end joint that curls under itself
- Painful calluses or corns
- Redness or a painful corn on top of the bent joint or at the tip of the affected toe, because of persistent rubbing against shoes
- Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes
Prevention of Hammertoe and Mallet Toe
- Wear wide, comfortable shoes that have plenty of room for the toes.
Diagnosis of Hammertoe and Mallet Toe
- Examination of the affected toe is required.
- X-rays may be taken.
How to Treat Hammertoe and Mallet Toe
- Wear wide shoes with plenty of room in the toes and resilient soles. Avoid wearing shoes with pointed toes.
- Commercially available felt pads or cushions may ease pressure from the shoe on the toe. Toe caps (small, padded sleeves that fit around the tip of the toe) may relieve the pain of hammer toe.
- Do toe exercises, to help toe muscles become stronger and more flexible.
- Arch supports or an orthotic shoe insert prescribed by your doctor or podiatrist may help to redistribute weight on the foot. These devices do not cure the problem but may ease the symptoms of either hammer toe or mallet toe.
- Surgery to realign the affected joint may be recommended if pain persists despite treatment.
When to Call a Doctor
- Make an appointment with your doctor or a podiatrist if you experience continuing pain on account of a hammertoe or mallet toe, if the affected toe interferes with walking or other activities, or if the rubbing produces a sore or ulceration.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media