Morton’s neuroma is inflammation of the nerves between the metatarsal bones of the foot.

The Pain of a Hammer Toe

Wearing shoes that don’t fit properly can result in several painful foot symptoms – one being a condition called hammer toe. When this happens, the toe is bent sharply at the middle joint, so that it resembles a hammer. When symptoms first appear, the afflicted toes are flexible and can still be corrected simply with physical therapy and by wearing shoes that fit. If this condition is left untreated, the damaged toe can become permanently bent and require surgery to correct.

Hammer toe occurs when the toe is bent in one position so long that the muscles and joints tighten and cannot stretch out normally. Wearing shoes that narrow toward the toe (high heels) cause the smaller toes to flex into a bent position. In this position, the toes also rub against the shoe, frequently causing corns and calluses, which only aggravates the condition. Over time the toe muscles become incapable of straightening the toe. This is a painful condition, especially when walking.

Nonsurgical Treatment

While in the early stages the joint is still flexible. At this point it is best to avoid wearing tight, narrow, high-heeled shoes. Properly fitting shoes should be a half inch longer than the longest toe (usually the second toe) and have a soft, roomy toe box. Finding a shoe that accommodates the hammer toe with a wider toe box may also be recommended. Wearing sandals is also a good idea.

There are several exercises that help stretch and strengthen the muscles in the foot. One such exercise entails gently stretching the toes manually and using the toes to pick up small items off the floor. There are also commercially available straps, cushions or nonmedicated corn pads that may help relieve pain.

Surgical Treatment

When the toe joint becomes rigid and immoveable, and when nonsurgical treatment does not relieve symptoms, surgery may be recommended. Surgery is typically performed on an outpatient basis using a local anesthetic. The actual procedure will depend on the type and extent of the deformity.

When the toe joint is still flexible the condition may be treated by lengthening the tendons that are causing the joint imbalance.

Some patients may benefit from treatment that involves transferring tendons from the bottom of the toe to the top of the toe to help pull the joint into a straight position.

Patients who have a rigid toe joint may undergo tendon lengthening in combination with arthrodesis. In this procedure, a small part of a bone is removed in the toe joint to ensure that the toe can extend fully. An external wire or pin is then inserted and/or an internal plate is set to hold the bones in place while the bones fuse together.

Recovery may include some stiffness, swelling and redness in the toe for up to six weeks. Patients are cautioned to try to limit activity while the toe heals. Elevating the foot as much as possible helps speed up healing and reduce pain. Once healed, the toe may be slightly longer or shorter than it was before.

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SRO’s Foot and Ankle Center provides services to patients throughout Sonoma County including; Santa Rosa, Petaluma, Rohnert Park, Windsor, Healdsburg, Sebastopol, California.  Foot and Ankle surgeon Dr. Mark Schakel understands the importance of a comprehensive evaluation in order to develop a proper diagnosis. As experts in foot and ankle disorders, foot and ankle trauma as well as sports medicine, we use the latest treatments and surgical techniques to restore function and relieve pain. We invite you to come and see what makes our patients so satisfied with their care.