Diseases & Conditions

Hammertoe and mallet toe

A hammertoe is a toe that's curled due to a bend in the middle joint of a toe. Mallet toe is similar, but affects the upper joint of a toe. Otherwise, any differences between hammertoe and mallet toe are subtle.

Both hammertoe and mallet toe are commonly caused by shoes that are too short or heels that are too high. Under these conditions, your toe may be forced against the front of your shoe, resulting in an unnatural bending of your toe and a hammer-like or claw-like appearance.

Relieving the pain and pressure of hammertoe and mallet toe may involve changing your footwear and wearing shoe inserts. If you have a more severe case of hammertoe or mallet toe, you may need surgery to experience relief.

Signs and symptoms of hammertoe and mallet toe may include:

• A hammer-like or claw-like appearance of a toe
• In mallet toe, a deformity at the end of the toe, giving the toe a mallet-like appearance
• Pain and difficulty moving the toe
• Corns and calluses resulting from the toe rubbing against the inside of your footwear

Both hammertoe and mallet toe can cause pain with walking and other foot movements. 

When to see a doctor
See your doctor if you have foot pain that's persistent and that affects your ability to walk properly and carry out other motions with your foot. Also, see your doctor if one or more of your toes has developed a clenched or claw-like appearance.

Your doctor can diagnose hammertoe or mallet toe by examining your foot.

If your toe is still flexible, your doctor may recommend that you change to roomier and more comfortable footwear and that you wear shoe inserts (orthotics) or pads. Wearing inserts or pads can reposition your toe and relieve pressure and pain.

If your toe has become tight and inflexible, your doctor may recommend surgery. The specific procedure depends on how much flexibility is left in your toe:

• If your toe has some flexibility, your doctor may straighten it by making an incision in the toe and releasing the tendon.
• If your toe is rigid, your doctor may not only cut or realign tendons but also remove some pieces of bone to straighten your toe. This procedure may require that the bones be fixed temporarily with pins while your toe heals.

Usually, you can go home from the hospital on the day of your toe surgery.

Wearing proper footwear may ease your foot pain. Low-heeled shoes with a deep toe box and flexible material covering the toes may help. Make sure there's a half-inch of space between your longest toe and the inside tip of your shoe. Allowing adequate space for your toes will help relieve pressure and pain.

In addition, your doctor may suggest exercises you can do at home or at work to strengthen your toe muscles. These may include:

• Picking up marbles with your toes
• Stretching your toe muscles

Don't try to remove a corn yourself using such methods as over-the-counter acid treatment, cutting or shaving. Home treatments can cause serious problems, especially if you have diabetes or poor circulation. Breaking the skin could result in an infection — in some cases, an infection serious enough to require amputation.