5 Things You Should Know About Painful Toe Deformities

Understanding hammertoe, mallet toe and claw toe

Woman's feet with hammertoes and bunions

Does one of your toes appear to bend in an awkward way or curl under painfully? If so, you may have a hammertoe, a toe deformity characterized by shortening and hardening of muscles, tendons or other tissue.

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A hammertoe is a term that describes symptoms and joint changes involving the toes. However, there are several other types of toe deformities, including:

  • Mallet toe
  • Claw toe
  • Adductovarus deformity of the 5th digit

“The deformity classification depends on where on the toe the contracture is,” says orthopedic surgeon Nicole Nicolosi, DPM.

These deformities sometimes need surgery, but there are several less invasive ways to ease pressure and relieve the pain they cause.

If you have one of these, here are five things you should know:

1. There are two types of toe contractures:

  • Flexible: Affected toes can still move at the joint
  • Rigid: Surrounding tendons and tissues permanently tighten and the joint becomes fixed and immobile

Without treatment, a flexible hammertoe sometimes becomes a rigid hammertoe, Dr. Nicolosi says.

RELATED: How to Choose The Best Shoes For Your Feet 

2. Muscle imbalance causes these deformities

“A toe deformity occurs when the muscle operating the toe becomes weak and another muscle overpowers that muscle,” says Dr. Nicolosi. “This results in contracture of the toe.”

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This muscle imbalance sometimes has a genetic or intrinsic component. If you have a high arch or flat feet, this can cause inherent instability in your foot when you walk.

Extrinsically, an injury to the toe, often caused by the shoes you choose, also sometimes causes the imbalance.

“One thing that can cause injury is long-term inappropriate shoe wear, which can compress the digit and cause muscle imbalance to occur,” Dr. Nicolosi says. She lists high heels and unsupported flip-flops as examples of inappropriate shoe gear.

RELATED: How Switching Up Your Summer Shoes Helps Your Feet

3. Hammertoe can interfere with daily activities

The digital contracture can result in rubbing on the top of the shoe.

“That can cause formation of callus tissue, which can be painful,” Dr. Nicolosi says. “The callus can then increase pressure in shoe gear, which then increases pain and therefore limits activity.”

4. You may not need surgery to ease the pressure and pain in your toes

Doctors can treat flexible hammertoes conservatively, Dr. Nicolosi says.

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They may suggest a crest pad or a Budin splint; each has an elastic band that goes around the crooked toe to bring a flexible hammertoe back into the corrected position.

“Another option is an in-office flexor tenotomy, which is used to cut the overpowering tight muscle tendon to correct the muscle imbalance and reduce the deformity,” she says.

For a rigid hammertoe, your doctor may suggest wearing a shoe with a deeper, fuller toe box to ease the pressure on the deformity. If this doesn’t solve the problem, however, surgery to straighten the toe likely is needed, Dr. Nicolosi says.

RELATED: 7 Ways to Ease Your Bunions Without Surgery

5. Wearing the right shoes can prevent symptoms from worsening

“Toe deformities develop due to unsupported motion,” says Dr. Nicolosi. “So one thing you can do to prevent symptoms from worsening is to avoid non-supportive shoes, such as high heels and unsupported flip-flops.”

She recommends a supportive shoe insert to control abnormal foot motion, as well as a supportive shoe.

RELATED: Best Ways You Can Treat, Prevent Hammertoe

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