Hammertoe and Mallet Toe

Overview

Hammertoe and mallet toe are foot conditions characterized by an abnormal bend in the joints of one or more toes. These bends typically occur in the second, third, or fourth toes. Hammertoe has an unusual bend in the middle joint, while mallet toe has a bend in the joint nearest the toenail. Both conditions can be caused by wearing ill-fitting shoes, foot injuries, or certain diseases like diabetes. Symptoms include pain, difficulty moving the affected toe, toe stiffness, redness, and swelling. Prevention involves wearing shoes with enough toe room, low heels, and avoiding pointed toe shoes. Treatment options may include changing footwear or using shoe inserts, but surgery may be necessary if other treatments are ineffective. If you experience lasting foot pain affecting your ability to walk, it's recommended to consult a healthcare provider.

Understanding the disease

Symptoms

The symptoms of hammertoe and mallet toe include:

• An unusual bend in the joints of one or more toes
• Pain from wearing shoes
• Difficulty moving the affected toe
• Toe stiffness
• Redness and swelling
• Growth of corns and calluses from rubbing against shoes or the ground If you are experiencing any of these symptoms, you should see a healthcare provider for further evaluation and treatment.

Risk Factors

Risk factors for developing hammertoe and mallet toe include:

1. Wearing shoes that don't fit well: Shoes that are too tight in the toe area can crowd the toes, causing them to bend and remain curled even when not wearing shoes.
2. Certain diseases: Arthritis and diabetes can increase the risk of foot problems, including hammertoe and mallet toe.
3. Women are more likely to develop hammertoe or mallet toe than men.
4. Genetics might play a role in developing hammertoe and mallet toe.
5. Trauma to the foot: A toe that has been stubbed, jammed, or broken might be more likely to develop hammertoe or mallet toe.
6. Imbalance of toe muscles: If the muscles aren't balanced, they can put pressure on tendons and joints, leading to hammertoe and mallet toe over time. Remember that preventive measures, such as wearing well-fitting shoes with enough toe room, low heels, and avoiding high heels, can help reduce the risk of developing hammertoe and mallet toe.

Development

Hammertoe and mallet toe develop due to a bend in the joints of the toes, typically caused by wearing shoes that don't fit well, foot injury, or certain illnesses like diabetes. The condition often occurs in the second, third, and fourth toes. Wearing ill-fitting shoes that crowd the toes can cause the toe muscles to become unbalanced, leading to pressure on the tendons and joints, eventually resulting in hammertoe or mallet toe. Other factors that can contribute to the development of these foot problems include certain diseases like Charcot-Marie-Tooth disease, sex (women are more likely to develop hammertoe or mallet toe than men), and trauma to the toes.

Assessment and Diagnosis

Triage

You should see a doctor if hammertoe and mallet toe are suspected when there is lasting foot pain that affects your ability to walk.

Management and Treatment

Complications

Potential complications of hammertoe and mallet toe include difficulty moving the affected toe, toe stiffness, redness, and swelling. The continuous rubbing against shoes or the ground can lead to the growth of corns and calluses. In severe cases, the tendons and joints may tighten, causing the toe to stay bent, and excess pressure on the bone of the toe tip can cause painful corns or calluses.

Prevention

Hammertoe and mallet toe can be prevented to some extent by wearing properly fitting shoes that have enough toe room and low heels. Avoiding high-heeled shoes and tight footwear that can crowd the toes and cause pressure on the joints can help reduce the risk of developing these foot conditions. Additionally, maintaining a healthy lifestyle, exercising regularly, and managing underlying conditions like diabetes can also help prevent or minimize the risk of hammertoe and mallet toe.

Treatment

Treatment options for hammertoe and mallet toe may include:

1. Changing footwear: Wearing properly fitting shoes that provide enough space for the toes can alleviate pressure and help prevent further bending of the toes.
2. Shoe inserts: Arch supports or shoe inserts can help distribute pressure evenly and reduce pain.
3. Padding or orthotics: Placing padding or using custom orthotics in your shoes can help reduce pressure on the affected toes.
4. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help relieve pain and inflammation associated with hammertoe and mallet toe.
5. Physical therapy: A physical therapist can teach you exercises to stretch and strengthen the muscles in your feet and toes, which may help improve flexibility and alleviate pain.
6. Surgery: In more severe cases, surgery may be necessary to correct the bend in the toe or to release tension in the tendons or joints. It's important to consult with a healthcare provider or foot specialist to determine the best treatment approach for your specific condition.

Preparing for medical consultation

To prepare for an appointment for hammertoe and mallet toe, you should:

1. Be aware of any pre-appointment restrictions, if any, that your healthcare provider may have mentioned when scheduling the appointment.
2. Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
3. Write down key personal information, such as any injuries to your toes or major stresses you are experiencing.
4. Make a list of all medications, vitamins, or supplements that you are taking.
5. Consider bringing a family member or friend along to the appointment for support and to help remember any important information discussed during the appointment.
6. Bring your previous scans or X-rays (both the images and the reports) and any other medical records relevant to your condition to the appointment. Remember to prepare a list of questions to ask your healthcare provider, such as asking about the likely cause of your foot problems, other possible causes, the best course of treatment, and whether you are a candidate for surgery.