17038 Hammertoes

Overview

A hammertoe is a toe that bends downward at the middle joint, so it looks like a hammer. It often affects the second, third, or fourth toe. The bent toe may rub against your shoe, causing pain, corns, or calluses. It usually develops slowly and can often be helped without surgery.

Yes. Hammertoes are very common, especially as people get older. They affect millions of people around the world, and women are more likely to develop them than men, partly because of footwear.

A hammertoe can happen at any age, but it is most common in adults over 40. You are more likely to develop it if you have longer-than-usual toes, flat feet, high arches, or if you often wear tight or high-heeled shoes. People with rheumatoid arthritis or diabetes are also at higher risk.

Symptoms

Common symptoms

• A toe that curves downward at the middle joint, like a hammer
• Pain, soreness, or a burning feeling on or under the toe
• Corns, calluses, or blisters where the toe rubs against the shoe
• Difficulty finding comfortable shoes
• The toe feels stiff or will not lie flat
• Swelling or redness around the affected toe joint

Symptoms in children

• Hammertoe is less common in children, but it can happen.
• A child may not feel pain at first, but you might notice a toe that is bending or rubbing.
• If your child complains of foot pain, has trouble walking, or you notice a toe shape that seems unusual, have it checked by a doctor.

Symptoms in older adults

• In older adults, hammertoes are often more stiff and fixed in the bent position.
• Corns, thick calluses, and hard skin may build up on top of the toe.
• Balance can be affected, so comfortable, stable shoes are especially important.
• Older adults should check their feet regularly and ask their doctor or a foot specialist for help if they notice changes.

Causes

Main causes

• An imbalance in the muscles and tendons that move the toes
• Wearing shoes that are too short, too narrow, or have high heels, which squeeze the toes into a bent position
• An injury to the toe, such as stubbing it badly
• Long-term conditions like rheumatoid arthritis or other joint problems
• Nerve or muscle damage that affects the foot
• Genetics — foot shape and toe length can run in families

Risk factors

• Being female
• Being over the age of 40
• Having a longer second toe or other uneven toe lengths
• Having flat feet or very high arches
• Having tight calf muscles
• Living with rheumatoid arthritis, diabetes, or a condition that affects the nerves in the feet
• Having had a previous foot injury or foot surgery

When to see a doctor

See a doctor urgently if:

• You have symptoms of infection, such as increasing redness, warmth, swelling, or pus coming from a corn or blister.
• You have diabetes and develop any foot wound, blister, or sore.
• Your toe suddenly becomes very painful, blue, pale, or cold.

Book a routine appointment if:

• You have toe pain that keeps coming back or makes daily walking uncomfortable.
• Your toe is bending more over time.
• You have corns or calluses that keep returning.
• You are struggling to find comfortable shoes because of your toes.

Diagnosis

A doctor can usually diagnose a hammertoe by looking at your foot and gently moving your toe. They will check both feet, look at how the toe bends when you stand and sit, feel for tender areas, and ask about your footwear and any conditions you have, such as arthritis or diabetes.

Tests that may be done

• X-ray of the foot to look at the toe joint and rule out fracture or arthritis
• Physical examination of the toes, foot strength, and flexibility
• Walking assessment to see how your foot moves when you take steps
• Nerve examination if the doctor suspects nerve-related weakness or numbness

What to expect at your appointment

Most people do not need any special preparation for the visit. You may need to remove your shoes and socks so the doctor can see both feet. They may ask you to stand, sit, and walk a few steps. Depending on what they find, they may advise treatments at home or refer you to a podiatrist — a foot specialist — or an orthopaedic foot surgeon.

Treatment

Treatment depends on how flexible or fixed the hammertoe is. If it is still flexible, simple measures such as roomier shoes, toe stretches, and padding may be enough. If it is fixed and painful, your doctor may offer extra options like custom shoe inserts, splints, physiotherapy, or, in some cases, surgery.

Self-care at home

• Wear shoes with a roomy toe box and a low heel, so your toes have space to lie flat.
• Use over-the-counter toe pads, felt cushions, or gel toe separators to reduce rubbing — ask your pharmacist which type is right for you.
• Stretch your toes and calf muscles gently every day.
• Soak your feet in warm water and keep the toe moisturised to soften corns.
• Do not cut corns or calluses yourself, especially if you have diabetes or poor circulation.
• Rest and raise your foot after long periods of standing or walking.

Medical treatments

Your doctor may suggest a medicine to reduce pain and swelling — always ask your doctor or pharmacist which product is safe for you. Other options include custom-made shoe inserts or orthotics, protective padding and splints, physiotherapy to strengthen the foot muscles, or steroid injections to reduce inflammation. If you have an underlying condition like diabetes or rheumatoid arthritis, your doctor will also help you manage that to protect your feet.

When is surgery considered?

Surgery is usually considered only if non-surgical options have not relieved pain. The procedure often involves releasing a tight tendon or straightening the joint. It is usually done under local anaesthesia, meaning you are awake but the foot is numbed. Recovery may take several weeks, and you may need to wear a special shoe. Most people who have surgery for hammertoe get significant pain relief and improvement in toe position.

Living with this condition

Living with a hammertoe is mostly about daily foot comfort. Wearing the right shoes, checking your feet regularly, and doing simple stretches can make a big difference. If one pair of shoes causes pain, switch to a different pair and give your feet a rest.

Lifestyle tips

• Choose supportive shoes that fit well — aim for a soft, wide toe box and a low heel.
• Do gentle toe-and-calf stretches each morning or after sitting for a long time.
• Check your feet daily for red spots, blisters, corns, or sores, especially if you have diabetes.
• Ask your doctor about seeing a podiatrist if you notice the bend getting worse.
• Avoid high-heeled or pointed shoes for everyday use.

Diet and exercise

Low-impact activities such as swimming, cycling, and walking in comfortable shoes can help keep your foot muscles and joints healthy. A balanced diet supports your overall health and helps you maintain a healthy weight, which reduces pressure on your feet. If standing or walking hurts, take short rest breaks and try gentle foot exercises.

Mental health and emotional wellbeing

Living with foot pain can make you less active, and that can affect your mood. It is normal to feel frustrated, worried, or low when pain keeps you from doing things you enjoy. Talk to your doctor about better pain control and let friends or family know what you are going through. If you ever feel overwhelmed or have thoughts of harming yourself, contact your local mental health crisis service or call your local emergency number.

Prevention

You cannot always prevent a hammertoe, especially if it runs in your family. But you can lower your risk by wearing shoes that do not squeeze your toes, avoiding very tight or high-heeled shoes for long periods, and keeping your foot muscles flexible with stretching. If you already have a mild hammertoe, these steps can also keep it from getting worse.

Vaccines

Not applicable. There is no vaccine that prevents hammertoes.

Screening programmes

If you have diabetes, it is important to have a foot check as part of your regular health review. If you have persistent foot pain or structural changes, a podiatrist can screen for early signs of toe problems before they become painful.

Complications

If left untreated

• The toe may become fixed and stiff, making treatment more difficult later.
• Corns, calluses, blisters, and open sores may form where the toe rubs against shoes.
• Persistent pain can make walking, balance, and daily activities harder.
• If you have diabetes or poor circulation, a small sore can become infected and slow to heal.

Long-term outlook

The outlook is generally good. Many people get complete relief with simple measures like better shoes and exercises. If surgery is needed, most people return to normal activities within weeks or months. The earlier you seek help, the easier it is to keep the toe flexible and pain-free.

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