Hammertoe and mallet toe

Hammertoe and mallet toe are foot problems that cause a bend in a toe or toes. Wearing shoes that don't fit well can cause hammertoe and mallet toe. Other causes are foot injury and certain illnesses, such as diabetes. Often the cause isn't known.

A hammertoe has an unusual bend in the middle joint of a toe. Mallet toe has a bend in the joint nearest the toenail. Hammertoe and mallet toe usually occur in the second, third and fourth toes.

Changing footwear, wearing shoe inserts, and using other devices might relieve the pain and pressure of hammertoe and mallet toe. Surgery can correct the condition and relieve the pressure if these treatments don't work.

Hammertoe and mallet toe have an unusual bend in the joints of one or more of the toes. Other symptoms include:

• Pain from wearing shoes.
• Difficulty moving the affected toe.
• Toe stiffness.
• Redness and swelling.
• Growth of corns and calluses from rubbing against shoes or against the ground.

When to see a doctor

See a health care provider if you have lasting foot pain that affects your ability to walk.

Hammertoe and mallet toe have been linked to:

• Certain shoes. High-heeled shoes or footwear that's too tight in the toe can crowd toes so they can't lie flat. In time, the toe might remain curled even when not in shoes.
• Trauma. A toe that has been stubbed, jammed or broken might be more likely to develop hammertoe or mallet toe.
• Imbalance of the toe muscles. If the muscles aren't balanced, they can put pressure on the tendons and joints. This imbalance can lead to hammertoe and mallet toe over time.

Factors that can increase the risk of hammertoe and mallet toe include:

• Sex. Women are more likely to develop hammertoe or mallet toe than are men.
• Certain diseases. Arthritis and diabetes can increase the risk of having foot problems. Genes also might play a role.

For a while, the toe still might be able to unbend. But over time, the tendons and joints of a hammertoe or mallet toe might tighten. This can cause the toe to stay bent.

Shoes can rub against the higher part of the bent toe. The bent position also may lead to excess pressure on the bone of the toe tip instead of the fat pad on the toe. This can cause painful corns or calluses.

Shoes that fit well can prevent many foot, heel and ankle problems. Here's what to look for when buying shoes:

• Enough toe room. Avoid shoes with pointed toes.
• Low heels. Not wearing high heels will help prevent toe and back problems.
• Shoes that adjust. Shoes with laces or straps are roomier and easier to make feel comfortable.

These added tips can help buying the right shoes:

• Shop at the end of the day. Feet swell as the day goes on.
• Check size. Shoe size — especially the width — can change with age. Measure both feet and buy for the larger foot.
• Buy shoes that fit right away. Be sure shoes are comfortable before you buy them. A shoe repair store might be able to stretch shoes in tight spots, but it's better to buy them to fit.

To diagnose hammertoe or mallet toe, a health care provider inspects the foot. X-rays can help show the bones and joints of the feet and toes. But they're not always needed.

For toes that can still unbend, roomier footwear and shoe inserts, called orthotics, or pads might give relief. Inserts, pads or taping can move the toe and ease pressure and pain.

Also, your health care provider might suggest exercises to stretch and strengthen toe muscles. These might include using toes to pick up marbles or scrunch a towel.

If these treatments don't help, your care provider might suggest surgery. The surgery can release the tendon that's keeping the toe curled up. Sometimes, the surgeon also removes a piece of bone to straighten the toe.

Good footwear can ease foot pain. Wear low-heeled shoes with a big toe box made of material that has some give to it. Make sure there's a half-inch (1.27 centimeters) of space between your longest toe and the inside tip of the shoe. Having enough space for your toes will help relieve pressure and pain.

If you're having a problem with your feet, you'll likely start by seeing your primary care provider. Or you may be referred to a foot specialist, either a podiatrist or orthopedist.

What you can do

Before your appointment, make a list of:

• Your symptoms, including any that seem unrelated to your foot problems, and when they began.
• Key personal information, including injuries to your toes.
• All medicines, vitamins or other supplements you take, including doses.
• Questions to ask your health care provider.

For hammertoe or mallet toe, some basic questions to ask your doctor include:

• What's likely causing my foot problems?
• What are other possible causes?
• What tests do I need?
• Am I likely to have this condition over time?
• What's the best course of action?
• Am I a candidate for surgery? Why?
• Are there restrictions I need to follow?
• Should I see a specialist?
• Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

• How much pain are your feet or toes causing you?
• Where is the pain exactly?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• What type of shoes do you usually wear?