Weekend Doctor
By Dr. Thomas F. Vail

Hammertoes, a condition seen frequently in both men and women, can keep people from normal activities.

A hammertoe is formed from an abnormal balance of the muscles in the toes.

This causes increased pressures on the tendons and joints of the toe, leading to the contracture or bending of the toe at the first joint of the digit, called the "proximal interphalangeal joint."

This bending causes the toe to appear like an upside-down “V."

Any toe can be involved, but the condition usually affects the second through fifth toes, known as "the lesser digits."

A visit to your podiatrist can be the first step to relief.

First, the podiatrist will determine what type of hammertoes you have.

They could be flexible hammertoes, which are less serious because they can be diagnosed and treated while still developing, or rigid hammertoes, which are more developed and more serious.

Rigid hammertoes can be seen in patients who wait too long to seek professional treatment or in patients with severe arthritis.

The tendons in a rigid hammertoe become tight and the joint misaligned and immobile, making surgery the usual course of treatment.

The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery.

Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan.

Your doctor may recommend:

• Padding and taping, often the first step in a treatment plan. Padding the hammertoe prominence minimizes pain and allows you to continue a normal life. Taping may change the imbalance around the toes and relieve the stress and pain.
• Medication such as anti-inflammatory drugs and cortisone injections to ease acute pain and inflammation caused by the joint deformity.
• Orthotic devices like custom shoe inserts made by your podiatrist, which may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe deformity.

If these treatments are not effective, several surgical procedures are also available to the podiatric physician.

For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, which relieves pain.

Severe hammertoes, which are not fully reducible, may require more complex surgical procedures.

Hammertoes are common and don't need to be a pain.