Hammertoe

Written by Timothy Gower, WebMD Editorial Contributor
Medically Reviewed by Zilpah Sheikh, MD on November 13, 2024
6 min read

A hammertoe happens when the muscles and ligaments around your toe joint get out of balance. This makes the middle joint of your toe curve upward and get stuck in this position. You’re most likely to develop hammertoe in your middle three toes. 

There are two types:

Flexible hammertoes. If you can still move your toe at the joint, it's a flexible hammertoe. That's good because it means you have a milder form of the problem. There may be several treatment options.

Rigid hammertoes. If the tendons in your toe become rigid, they press the joint out of alignment. At this stage, you can’t move your toe. It usually means you need surgery. 

Hammertoe and mallet toe are two related conditions that can affect your toe joints. Both conditions typically occur in the middle three toes. However, hammertoe causes the middle joint in a toe to bend upward, giving it a crooked appearance. In contrast, mallet toe causes the joint closest to the tip of a toe to bend downward.

The main symptom of hammertoe is a toe or toes that bend upward at the middle joint. Because of these buckled toes, you may have:

  • Blisters and calluses from where your toes rub against the top of your shoes
  • Pain in your toe joint where it meets your foot
  • Pain when you walk
  • Stiffness in the bent toes that gets worse over time

The muscles of each toe work in pairs. When the toe muscles get out of balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on your toe's tendons and joints. This pressure forces your toe into a hammerhead shape.

Causes include:

  • Shoes that don’t fit. If your shoes are too tight or too small, they push your toes out of balance. 
  • Wearing high heels. Pointy, high-heeled footwear squishes your toes and smushes them into the front of the shoe. That severe pressure on the toes can cause hammertoe and other problems.
  • Having long toes. If your lower digits are extra long, you may have a hard time finding shoes that accommodate their length. Ill-fitting shoes can put pressure on toes, causing them to bend. 
  • Having high arches or flat feet. Both can set the stage for hammertoe. 
  • Having bunions: A bunion occurs when your big toe gets pushed out of alignment, putting pressure on your other toes.
  • Injuries. Trauma to your toes may cause hammertoe to develop. 
  • Your genes. Some people are born with hammertoes.

Your risk for hammertoe rises as you age. Also, women are more likely than men to get pain from hammertoes because of the types of shoes they wear. Having certain health conditions can also increase your risk for developing hammertoe, including:

  • Arthritis
  • Alcoholism
  • Charcot-Tooth-Marie disease, a disorder that damages the nerves in your arms and legs
  • Diabetes

Hammertoes can be a serious problem in people with diabetes or poor circulation because they have a higher risk for infections and foot ulcers. Custom orthopedic shoes may prevent these complications. People with these conditions should see a doctor at the first sign of foot trouble.

Your doctor should be able to tell if you have hammertoes by looking closely at your feet and asking you about your symptoms. If they want more detailed information about your foot and toe joints or bones, you may also get an X-ray.

To relieve some of the symptoms of hammertoe, your doctor may suggest:

  • Roomier shoes that extend at least a half inch past your toes
  • Inserts or pads in your shoes that reposition your toes to relieve pain
  • Special exercises that stretch and strengthen your toes
  • Taping or splinting your toe to make it straight
  • Ice packs on your toes to relieve pain and swelling
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to help with pain and swelling
  • Steroid injections in severely swollen or painful toe joints

If your hammertoe is severe, you may have surgery to correct it. It may be an option if your pain has gotten very bad, your toe is very rigid, or you have an open sore because of your hammertoe. There are several surgery options:

  • Arthroplasty. The surgeon removes the tip of the toe bone, which allows the toe to lay flat.
  • Arthrodesis. The entire joint under your crooked toes is removed, and a wire is inserted to help it straighten as it heals.
  • Tendon transfer. The surgeon attaches tendons under your toe to the top of your toe to help it straighten out. 
  • Basal phalangectomy. The surgeon takes out the base of the bone under your hammertoe.
  • Weil osteotomy. The surgeon shortens certain bones in your foot and then puts screws in them.

Hammertoe surgery recovery

Your doctor will likely instruct you to rest with your foot raised at about the level of your heart for the first few days after your hammertoe surgery. You probably won’t need crutches, but you may need to wear a special boot on the treated foot. Your doctor will let you know when it’s safe to stop wearing the boot. In some cases, you may get a cast on your foot.

You’ll receive stitches in your treated toe during the surgery, which your doctor will remove after a few weeks. If your surgeon inserted pins to stabilize your joint after treatment, they’ll come out, too. Until then, you can’t submerge your foot underwater. After about one month, you can go back to wearing your loose-fitting shoes. 

Your doctor may recommend physical therapy to help you recover or give you exercises to do at home.

Strengthening and stretching your foot muscles can help you manage hammertoe. Try these exercises:

Toe curls. Place a towel on the floor, put your bare foot on top, and curl your toes to snag it. You can also do this with a marble.

Toe stretch. While seated, lean forward and grasp your toe. Pull it gently toward your ankle and hold for 15 to 30 seconds. Relax and repeat up to four times. Do this several times a day.

Toe raise. While standing barefoot and supporting yourself (such as by placing your hands on the kitchen counter), rise up on your toes and hold the position for 10 seconds. Repeat five times.

Taping your hammertoe to a neighboring toe can help keep it straight. There are various methods for taping a hammertoe. Ask your doctor to show you the proper technique.

If you have a hammertoe, you may also develop other problems with your toes and feet, including:

  • Corns
  • Calluses
  • Open sores that can lead to infection
  • Bursitis, or painful inflammation of fluid-filled sacs in the feet
  • Tendinitis, or inflammation of tendons in the foot

Hammertoe is a common problem that causes one or more of your toes to curl upward at the middle joint. You can reduce your risk for hammertoe by avoiding tight shoes and high heels, but some people can develop this condition simply by having high arches or flat feet. Certain medical conditions can increase your risk, too. A doctor can recommend conservative measures for managing hammertoe, though some cases require surgery.

When should I see a doctor for hammertoes?

See a doctor if your hammertoe hurts or is causing trouble with walking.

Is hammertoe a form of arthritis?

No, hammertoe is not a form of arthritis. However, some forms of arthritis may make you more likely to develop hammertoe.

Can you reverse a hammertoe?

A properly trained surgeon can make changes to bone and other structures to straighten out your hammertoe.

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