If one of your toes seems to be stuck in a bent position, it could be that you have hammertoe, a condition that can affect all five toes on your foot.

In the beginning, hammertoes may not be very bothersome, but they can get worse over time. The good news is that it’s possible to straighten a hammertoe by making changes and seeing a doctor. Read on to learn if you have hammertoes, what causes them and what you can do about it.

What hammertoe looks like: Bent or curled toes

A hammertoe refers to joint contracture, which occurs in the small joints of your toes, causing them to become bent or curled instead of lying flat. This can make the toe look like a peak or a triangle that rises above your other toes – some might say a hammertoe looks like the head of a hammer. It’s possible to have more than one hammertoe at a time, and it can occur on any of the five toes.

It’s important to note that hammertoes look different depending on which joints are bent within the toe. (Sometimes we call these deformities mallet toes or claw toes, and we’ll touch on these conditions later in this post.)

Hammertoe symptoms get worse over time

When your hammertoe is in an early stage, you may not have a lot of symptoms. As your toe gets worse, it tends to cause more pain and affect your ability to walk and enjoy life.

Stages of hammertoe

Foot specialists group hammertoe into three stages.

Hammertoes can change from flexible to rigid

When hammertoes start to develop, you may be able to straighten your toe. But as time goes on, the tendons and joints can tighten. Eventually, you won’t be able to straighten your toe and it may get stuck in a stiff, claw-like position.

Hammertoe can be painless or painful

Pain is the most common symptom of hammertoes, but hammertoes may not cause any discomfort in the initial stages. And if you have a medical condition that affects sensations in your feet (such as nerve damage from uncontrolled diabetes), you may not feel hammertoes at all, even when it’s completely rigid.

What hammertoe feels like varies from person to person, but may include:

• Aching
• Discomfort
• Tightness
• Swelling
• Shooting pain

Hammertoe pain is often the worst when wearing shoes. This is because your toe is pressed into an uncomfortable and unnatural position. Also, your toe is likely to rub against the top of the shoe or other toes. As a result, the skin may become irritated and develop corns, calluses and open sores/wounds that can make your foot pain (and hammertoe) worse. Any open wounds, especially diabetic wounds, put you at risk of infection and you should seek treatment right away.

Hammertoe can affect your ability to stand and walk

Your toes are important. When standing, your toes help you keep balance. When walking, they help push you forward. But hammertoe changes how your foot functions. Normally, the pressure is on the bottom of your toe when you stand or walk. With hammertoes, that pressure is transferred to the tip of your toe.

Causes of hammertoe

Your muscles work in pairs to flex and stretch your toes as you move. But if you have hammertoes, these muscles are too tight, making it difficult or impossible to move or straighten your toe.

Most often, hammertoes develop on toes that spend a lot of time in an unnatural, uncomfortable, bent position. When toes stay in this position long enough, the muscles start to tighten up and become shorter.

Shoes that fit poorly

If you wear shoes that are too short, too narrow or too tight, it can push your toe into a bent position. And wearing shoes when your toe is in a hammertoe position makes it likely that you’ll develop calluses where the shoe rubs on the top of the toe joint or on the tip of your toe. These corns and calluses take up room in an already crowded space and can make hammertoe deformities even worse.

Other reasons for hammertoe

While improper footwear can contribute to the formation of hammertoes, there are several other factors that can be at play, including:

• Arthritis – Joint swelling from arthritis can affect how you walk and how your shoes fit, and joint stiffness can make it hard to move your toes. Because of this, your toe may get pushed into an unnatural position, and it may be difficult to unbend your toe.
• Bunions – If you have a bunion, your big toe may be pushed inward, causing the second toe to move into a hammertoe position.
• Foot anatomy – Flat, flexible feet or an especially high foot arch can create muscle imbalance that makes it more likely you’ll have hammertoes. If you have very long toes, there may not be enough room for them in common shoes sizes.
• Genetics – You’re more likely to develop hammertoes if someone in your close family had them. If you’re female, you’re more likely to inherit hammertoes.
• Trauma – Injuries to your toe can affect your muscles and tendons. If you’ve stubbed, broken or injured your toe, it may be more likely to develop hammertoe contractures.
• Nerve problems – Underlying nerve problems can lead to muscle imbalances in your legs that can cause hammertoe deformities.

How to prevent hammertoe and keep it from getting worse

Supportive shoes that fit well are one of the best ways to relieve foot pain and keep hammertoes from getting worse. Trying custom or over-the-counter orthotics (shoe inserts) will help support your foot structure and alleviate areas of increased pressure. Padding may be necessary to protect the skin on the top and tip of your toes from breaking down.

What to look for in shoes

Start by looking at the shoes in your closet to see if you have ones that may be kinder to your feet. In particular, look for the following:

• Enough toe room – You’ll want about a half-inch between the end of your longest toe and the inside edge of the shoe. Look for shoes with a wide toe box to accommodate all of your toes, and avoid shoes with a pointed toe, which can cramp your toes.
• Arch support – Proper arch support is beneficial for everyone, regardless of your foot type. Shoes that provide this support help your feet function properly and can prevent certain conditions from getting worse.
• Shoelaces or straps – Shoes with laces or straps can make it easier to have the right fit for your foot, no matter the time of day. Plus, they are often roomier.
• If you wear heels, keep them low – High heels usually have less toe room and increase the pressure on your toes when you wear them. You can help prevent toe (and back) problems by skipping the high heels.
• Shoes that stretch – You may be able to use a shoe stretcher to widen your shoes, or a shoe repair shop may be able to stretch your shoes for you.
• Comfy foot support for home – Avoid walking barefoot, even at home. Instead, opt for a house shoe or slipper that provides stable arch support and enough room for your toes.

Tips for shoe shopping

Here are a couple things to keep in mind when shopping for shoes:

• Try before you buy – It’s always best to try on shoes before you buy them, even if you’ve bought the brand before. Before making any decisions, see how the shoes feel when sitting, standing and walking. They should be comfortable in any position.
• Shop at the end of the day – Feet swell as you use them, so it’s best to shop for shoes at the end of the day.

Toe pads and positioners may help

There are a variety of pads, wraps and separators that can change how your toes sit within your shoes. When trying them, it’s important to consider how adding them will affect the amount of space your toes have in your shoes. Also, stop using them if they hurt your feet or your hammertoe gets worse.

Here are products that may work for you:

• Toe pads – Toe pads for hammertoes can protect the top or bottom of your toes from rubbing against the shoe. They may help with the pain and prevent skin breakdown, but they won’t fix hammertoes.
• Crest pads – These products are made to sit just beneath your toes, in what is called the toe crest. The pad will lift up the tip of your toe to prevent irritation, skin breakdown and wound development.
• Toe sleeves – These products are gel/silicone sleeves that will slide onto your toe. They help prevent irritation from shoes and adjacent toes.

Use over-the-counter pain relievers sparingly

Pain relievers like acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and swelling. But using them frequently or in high doses can cause other health problems, such as gastrointestinal issues, stomach ulcers and liver problems. If you’re regularly taking them, talk to your doctor about what’s safe for you.

To fix a stuck hammertoe, you’ll need a doctor’s help

Making footwear changes can help relieve symptoms, but you’ll likely need a doctor’s help to fix a hammertoe that’s semi-rigid or rigid. So if you can’t move your toe or don’t see improvements after a few weeks, make an appointment with a foot specialist, such as a foot and ankle surgeon.

Diagnosing hammertoe

The foot specialist will examine your foot and toes to see how your joints move. They’ll ask you about your symptoms and if they get better or worse depending on the shoes you wear. They may also ask you to stand up and walk around to properly assess your gait. If necessary, they’ll recommend X-rays to evaluate your underlying bone structure.

Physical therapy and toe exercises

Physical therapy can help stretch the muscles and tendons, which may relax tightened muscles and straighten out your toe. When you meet with a physical therapist, they’ll provide recommendations about exercises you can do at home to stretch and strengthen your toes. They may recommend you use your toes to pick things up off the floor. An easy way to do this is with “towel curls,” where you lay a towel flat on the floor and then use your toes to bunch it up.

Custom orthotics

Custom orthotics for hammertoes are designed to relieve pain and pressure on the affected toe joints. They work better than over-the-counter pads and shoe inserts because they are made to fit the unique needs and structure of your foot. Most of the time, custom orthotics work with regular shoes.

These orthotics provide additional cushioning and support where you need it and help keep toes in the appropriate position. This helps improve the distribution of weight on your foot when you move.

Surgery for hammertoe

Surgery may be necessary for hammertoe deformities, especially for rigid hammertoes and if other treatments haven’t improved your symptoms.

Surgery will address the underlying cause of the joint contracture, which may include tendon lengthening or balancing. Surgery may also involve removing a portion of the bone, and joint fusion may be necessary for your toe to lay completely flat. A foot and ankle specialist will determine the best type of surgery for your hammertoes.

Hammertoe variations

As mentioned above, curved or bent toes can also be a sign of mallet toes or claw toes. These are deformities that still cause the small joints in your toes to curl, but the contractures may look different. No matter what the underlying cause, it’s best to see a foot and ankle specialist if you are experiencing pain and worsening symptoms.

The difference between hammertoe, mallet toe and claw toe

• Hammertoe – As covered above, hammertoe affects the middle joint. As a result, the toe looks like an upside-down V.
• Mallet toe – This condition affects the third joint, which is the one closest to the toenail. So, if you have mallet toe, the very front of your toe may curl under.
• Claw toe – This condition always affects the first toe joint, but it may also affect the second joint. If you have a claw toe, it will bend up from the base of the toe and may curl under if other joints are affected.

We can help straighten out your toe problems

Toe problems like hammertoes shouldn’t be ignored. It’s normal for toes to be sore on occasion, but they shouldn’t be sore every day.

If you think you have hammertoes, mallet toes or claw toes, try making changes to your footwear. But if you’re experiencing daily pain or developing wounds, make an appointment with a foot and ankle specialist right away.

There are many treatments that can fix a hammertoe and return the toe to its normal shape. And the sooner you get help, the better. When hammertoe is treated at an earlier stage, it tends to get better faster.