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Hammer toe is a deformity affecting one of the smaller toes, most commonly the second, third or fourth toe. The middle joint of the toe bends abnormally, causing the toe to curl downward so that it resembles the shape of a hammer.
In the early stages the toe may still be flexible and can be straightened with gentle pressure. Over time, however, the soft tissues around the joint tighten and the deformity can become fixed. When this happens the toe may rub against footwear, leading to pain, calluses or corns.
Hammer toe is a common foot condition and can affect people of all ages, although it is seen more frequently in adults and in those who spend long periods standing, walking or wearing restrictive footwear.
Hammer toe can develop gradually over time and is often the result of an imbalance between the muscles, tendons and ligaments that normally keep the toes straight.
It is more commonly seen in:
Athletes and people who are on their feet for long periods can also develop hammer toe, particularly if footwear does not allow enough space for the toes.
Several factors can increase the likelihood of developing hammer toe. These include structural foot problems, footwear choices and certain medical conditions.
Common predisposing factors include:
Often there is not a single cause but rather a combination of these factors.
Symptoms usually develop gradually and may worsen over time if the toe becomes more rigid.
Common symptoms include:
In the early stages symptoms may only occur when wearing certain shoes or after long periods of walking or standing.
Certain activities and footwear choices can make hammer toe symptoms worse.
Common aggravating factors include:
Over time, repeated friction and pressure can lead to painful corns or skin irritation.
If hammer toe is causing persistent discomfort or affecting daily activities, an assessment by a specialist is recommended.
During your consultation at London Bridge Orthopaedics, your clinician will:
Understanding whether the deformity is flexible or rigid helps guide treatment decisions.
Hammer toe is usually diagnosed through a clinical examination.
In some cases, imaging such as X-rays may be recommended.
These can help:
Imaging is particularly helpful when surgical treatment is being considered.
Several other forefoot conditions can cause similar symptoms or toe deformities.
These may include:
A specialist assessment helps ensure the correct diagnosis and the most appropriate treatment plan.
In many cases, especially when the deformity is still flexible, symptoms can be managed without surgery.
Conservative treatments aim to reduce pressure on the toe, relieve discomfort and slow progression of the deformity.
These may include:
Wearing shoes with a wider toe box can reduce pressure on the toes and prevent rubbing. Avoiding tight shoes and high heels is often helpful.
Protective pads or silicone sleeves can reduce friction over the toe. Custom orthotics may help redistribute pressure across the forefoot and improve foot mechanics.
Gentle toe exercises may help maintain flexibility in the early stages.
Regular care from a podiatrist can reduce painful areas of thickened skin caused by shoe pressure.
While these measures can relieve symptoms, they do not usually correct an established toe deformity.
Surgery may be recommended when:
Modern surgical techniques are generally very effective at correcting hammer toe and relieving symptoms.
The aim of surgery is to straighten the toe, restore a more normal alignment and remove the source of pressure within footwear.
The most appropriate surgical technique depends on the severity of the deformity, whether the toe is flexible or rigid, and whether other forefoot problems are present.
In early or flexible hammer toe deformities, surgery may involve releasing or repositioning the tendons that are pulling the toe into a bent position.
This procedure allows the toe to return to a straighter alignment while preserving joint movement.
It is usually performed as a day-case procedure and recovery is relatively quick – 4-8 weeks.
For more established deformities, part of the small joint in the toe may be reshaped to allow the toe to straighten.
This procedure removes a small section of bone from the joint, relieving stiffness and allowing the toe to sit in a more natural position.
The toe may be temporarily supported with a small pin during healing, which is typically removed after a few weeks.
In more severe or rigid hammer toe deformities, fusing the joint may provide the most reliable correction.
During this procedure the small joint in the toe is permanently straightened and fused in position. Although the joint no longer moves, the toe sits straight and pain from the deformity is usually resolved.
Fusion procedures are commonly used when the joint has become stiff or arthritic.
Hammer toe often occurs alongside other forefoot problems such as bunions or instability in the ball of the foot.
In these situations, surgeons may correct multiple issues at the same time. Addressing the underlying cause of the deformity can improve long-term results and reduce the risk of recurrence.
Hammer toe surgery is usually performed as a day-case procedure, meaning patients go home the same day.
Recovery typically involves:
Your surgeon will provide detailed guidance on post-operative care and rehabilitation.
Surgery for hammer toe is generally very successful in relieving pain and improving toe alignment.
Most patients experience:
As with any surgery there are potential risks, but these are relatively uncommon and will be discussed during your consultation.
When appropriately selected, surgical correction of hammer toe can provide lasting relief and allow patients to return to normal daily activities with greater comfort.
In the early stages, when the toe is still flexible, symptoms can sometimes improve with simple measures such as wearing wider shoes, using protective padding and performing gentle toe exercises. However, once the deformity becomes fixed, it is unlikely to correct itself without medical treatment.
Hammer toe can be painful, particularly when the bent joint rubs against footwear. This can lead to pressure points, corns or calluses on the top of the toe. Some people also experience discomfort in the ball of the foot due to changes in weight distribution while walking.
You should consider seeing a specialist if the toe deformity is becoming more noticeable, if pain is affecting your daily activities, or if it is becoming difficult to find comfortable shoes. Early assessment can help prevent the condition from worsening and may allow more conservative treatment options.
Hammer toe surgery is usually performed as a day-case procedure and is typically well tolerated. Some discomfort and swelling are expected during the early recovery period, but this is usually manageable with simple pain relief and rest. Most patients notice significant improvement in symptoms once the toe has healed.
Surgery for hammer toe is generally very successful at correcting the deformity and relieving pain. Most patients experience improved comfort in footwear and better toe alignment. When the underlying cause of the deformity is also addressed, the long-term results are usually very good.
We are a group of established consultants who care about our patients. We cover all the subspecialty areas of orthopaedics:
Meet the team at London Bridge Orthopaedics.
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