High heels and pointed shoes force the toes down into the shoe or into a point. When toes don’t have enough room to lie flat, a hammer toe can develop, usually with a bunion.
Anyone with a family history of hammer toe is also more likely to develop the condition.
Duke orthopaedic surgeon Selene G. Parekh, MD, says there are several treatment options, starting with physical therapy for mild cases.
You can stretch the muscles and tendons to relieve the cramping and to straighten your toes. If your toe is also rubbing up against the underside of your shoe, you can also use small pads, found in most drugstores, to cover and protect the toe. “As far as conservative treatments options, though, that’s it,” Parekh says.
When that doesn’t work, surgeons traditionally remove some bone and insert a pin into the toe. The pin keeps the previously bent toe immobilized for four to six weeks while its bones fuse.
Though the surgery is effective, the pin remains sticking out of the person’s toe. If she isn’t careful when she begins walking, the pin can get caught on things or hit the ground.
A newer technique involves inserting the SmartToe implant into the toe instead of a pin. The bones fuse around the implant, which is permanent. “Think of the device as something similar to a pin but completely inside your bone,” Parekh says.
“One of the big benefits of implants is that you don’t have something sticking out of your toe.” While the length of recovery is the same as traditional surgery, the SmartToe gets people get back on their feet and walking faster than with the traditional pin, sometimes within days.
Parekh says it’s a good idea to seek medical attention if you have toe pain with or without shoes. Or, if shoes you used to find comfortable are no longer comfortable, see a foot expert or an orthopaedic surgeon who can discuss your options with you.
“I’ve had patients who have 200 or 300 pairs of shoes. They are emphatic when they say there is no way they’re getting rid of their shoes,” he says. “That’s okay. We can work with them as long as everyone understands we will eventually have to do surgery.”
Other people don’t care what shoes they wear. They just want relief from the pain and to walk comfortably again.
“After taking care of so many patients, one thing I can say is if your foot and ankle hurt, you will feel miserable,” Parekh says. “It really is worth taking care of your feet to prevent any long-term problems.”