Hammertoes Can Be Painful And They Usually Worsen In Stages.
Are your toes twisted, rigid, and painful? Do you have bent and crooked toes that are as painful as they look. Then you may have hammertoe (claw toe, mallet toe). Hammertoe (hammer toe deformity (severe hammertoe), claw toe deformity, hallux hammertoe) is a condition that affects one of the three middle toes, causing the toe to bend upward at its middle joint. Hammertoes most frequently involve the second toe, however, multiple toes can be involved. This abnormal bending can put pressure on the toe when wearing shoes, causing major foot problems to develop.
Normal toes unaffected by hammertoe (mild hammertoe) usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures and treatments. But if left untreated, hammertoes can become more twisted, rigid and painful and will not respond to nonsurgical treatment.
The hammertoe condition is usually manageable with lifestyle changes. If lifestyle changes don’t help reduce your pain, surgery may be a solution to this foot condition. Because hammertoes usually get worse if untreated, hammertoes should receive early attention.
As indicated earlier, hammertoes if left untreated become more progressive—they do not go away by themselves and usually they will get worse over time and some rapidly progress more than others.
Two Types Of Hammertoe Exist.
Flexible hammertoes are in the developmental stage and the affected toes are still flexible and moveable at the joint. There usually is only a slight noticeable pain at the on set.
Once the hammertoes progresses, they become more rigid and inflexible. Rigid hammertoes are more serious. The tendons tighten and the joints become misaligned and immobile.
What are the Causes of Hammertoes?
Hammertoes may be aggravated by shoes that do not fit properly or are ill fitting. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.
Hammertoes are caused by an abnormal muscle balance (tendons and joints pulling or stretching unnaturally) in the toes, which leads to increased pressures on the toe tendon and joints. Heredity, trauma, arthritis, and wearing tight shoes can all lead to hammer toe. Hammertoes as they progress become increasing more painful
As indicated earlier, tight ill-fitting shoes, earlier toe trauma or even hereditary causes can cause an imbalance in the muscles and tendons of your feet. This imbalance, leads to a bending of the toe resulting in an unnatural mechanical (structural) or neurological changes in the foot that occur over time in some people.
What Are The Symptoms Of Hammertoes?
Common symptoms of hammertoes include:
- Pain or irritation of the affected toe when wearing shoes that are ill fitting.
- The development of corns and calluses on the toe, between two toes or on the ball of the foot.
- Inflammation, redness or a burning sensation in the areas of the affected toes.
- Contracture or restricted bending of the toe.
- Open sores may form in severe cases.
What Are Conservative Hammertoe Treatments?
Temporary and conservative measures are usually the first line of hammertoe treatment and targeting the acute phase of the condition, as well as attempting to stop the progression of the condition to a more serious form.
There several ways to alleviate the pain caused by hammertoes but as previously mentioned hammertoes are progressive and will continue to get worse. To alleviate the pain, you may try the following:
- Put pads on the affected hammertoe to minimize pressure and taping the toes together to change the muscle imbalance. You can try over-the-counter pads, but avoid the medicated types as they may contain a small amount of acid that can be harmful.
- Alleviating pain through the use of anti-inflammatory drugs and cortisone injections. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
- Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels—conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
- Wearing custom shoe inserts to control foot function. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.
- Oral medications may be taken such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, may be recommended to reduce pain and inflammation.
- The use of splints or small straps may be applied by the surgeon to realign the bent toe.
- Exercises to stretch and strengthen your toe, such as scrunching up a towel with your toes, may help in some cases.
When Should Someone Seek Medical Treatment For Hammertoe?
Generally intense pain and the loss of toe mobility in the hammertoe area is the most contributing factor for patients finally seeing a foot specialist. Visually, severe deformity of the foot and the impossibility of being able to wear shoes is an indicator. Additionally, there may be a crackling sound in the joint when it moves.
Given the above symptoms, diagnosis of a hammertoe is based on a physical examination, a detailed history of the patient’s symptoms and their development over time, and xrays to determine the degree of deformity.
Making the proper diagnosis for hammertoe requires taking into account the medical history and all possible causative factors. Other foot disorders such as gout and medical conditions must be ruled out.
The patient history should include factors that increase the pain, the patient’s level of physical activity, occupation, amount of time spent on his or her feet, the type of shoe most frequently worn, other health conditions such as diabetes that can affect the body’s ability to heal, a thorough medication history, including home remedies, and any allergies to food, medications, or environmental aspects.
What Kind Of Doctor Treats Hammertoe?
Podiatrist, foot and ankle specialists, orthopedic and general surgeons are uniquely qualified to treat hammertoe among the medical professionals.
At the Podiatry: Foot and Ankle Center, we are the specialists and the medical facility to treat your hammertoe at the best hammertoe treatment surgery cost.
Who Is A Good Candidate For Hammertoe Surgery?
Surgery shouldn’t be a first option for hammertoe treatment. However, if home remedies and lifestyle changes do not alleviate your pain, then surgery maybe an option.
Surgery is recommended when there is severe pain that has hindered your day-to-day activities like simply walking. Or as the hammertoe condition has progressed your foot is severely deformed and rigid with extreme pain.
For less severe deformities, the surgeon removes the bony prominence on the toe and aligns the toe joint. Other surgical procedures include releasing a tendon that is too short, transferring a tendon to another location, and inserting a steel pin to correct the toe’s position.
Surgery for hammertoe aims to alleviate pain and enable the patient to resume regular activity wearing normal shoes. Although surgery helps the foot look more normal, appearance is not a primary goal.
Some people with hammertoe also have other foot problems, such as bunions, heel spurs, or corns. If you have multiple foot problems, your doctor may recommend treating all of them in one operation.
Patients with hammertoes have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
What Are The Risks For Hammertoe Surgery?
All surgical procedures involve some degree of risk. The most likely problems to occur in a hammertoe surgery are infection, pain, nerve damage to the operated foot, and the possibility that the hammertoe will recur. Sharing all pertinent past and present medical history with the surgical team helps to lower the chance of a complication. In addition to the risk of the surgery itself, anesthesia also has risks. It is important to share with the anesthesia team the list of all the vitamins, herbs, and supplements, over-the-counter medications, and prescription medications that you taking.
What To Expect During Foot Surgery For Hammertoes?
Hammertoe surgery is usually done as an outpatient procedure. That means you can go home the same day you have the surgery. You may receive general anesthesia so you’re asleep for the entire procedure. Your doctor may decide to do the surgery without general anesthesia, and instead use numbing medications so that you can’t feel any of the work being done on your foot. Discuss these options with your hammertoe specialist.
The type of procedure you have will depend on the severity of your hammertoe. If the toe is still somewhat flexible, the surgeon may be able to do a tendon transfer. This involves redirecting tendons from the bottom of the toe to the top where it’s bent. The rerouted tendons can then help straighten the toe.
If your hammertoe has become fixed or stiff, the surgeon has two options: joint resection or fusion.
In joint resection, an incision is made on the top part of the toe to reach the ligaments and tendons underneath. The ligaments and tendons may be cut to help straighten the toe. The end of one bone is taken off so that the toe can be fully extended. Small metal pins or rods are often used to keep the toe straight during healing. The pins are usually removed a month or so after surgery.
With fusion, ligaments and tendons are also cut to straighten the toe. In this procedure, however, the ends of the two bones that form the affected joint are cut to make the toe straight. Pins or screws are used while the ends of the bone heal or fuse together.
Your Recovery From Hammertoe Surgery.
Full recovery from hammertoe surgery (perhaps a big toe straightening surgery) may take a few weeks. The type of surgery will determine the timetable. You may get a special shoe to help you with walk and maintain your balance during your recovery. You may also need crutches or a walker during your claw toe surgery recover time from your hammertoe repair surgery.
You should try to keep your foot elevated most of the time in the first couple of weeks after hammertoe surgery. This will take pressure off the toe and allow it to heal. You can expect some swelling around the toe. Swelling could last up to a year, but the pain should subside fairly soon after the operation. If you have pins or screws in your toe, they may be taken out a few weeks after the operation.
If the operation was on your right foot, you will have to avoid driving for a few weeks. Be sure to ask your hammertoe specialist about any restrictions on driving or other activities. You also shouldn’t place your foot under water until the pins or screws are removed.
Are There Complications From Hammertoe Surgery?
All surgeries have risk of complications, including infection, nerve damage, blood clot formation, and a bad reaction to the anesthesia, if used during your surgery.
Complications specific to hammer toe surgery include the possibility that your toe could eventually curl up again. This is unusual, however. It’s also rare that the bones don’t heal properly after a fusion procedure.
Your Hammertoe Surgery Outlook. What Are The Expected And Normal Results Of Hammertoe Surgery?
If your hammertoe returns to normal from hammer toe surgery (claw toe surgery or toe straightening surgery) which are unlikely, a second surgery may be necessary. What’s more common is that you may only be able to bend your toe slightly after your hammer toe repair surgery or surgery to fix hammertoe. Some people are unable to bend their toe at all. This shouldn’t affect your walking or balance.
The expected result will depend on the degree of deformity that has occurred prior to your hammer toe surgery (mallet toe surgery), the patient’s medical condition and age, and the adherence to the recovery regimen prescribed. Some degree of swelling in the foot is normal for up to six months after the big toe straightening surgery or claw toe correction surgery.
Once wound healing has taken place, the hammertoe surgeon may recommend exercises or physical therapy to improve foot strength and range of motion. It is important to be realistic about the possible results before consenting to the surgery to fix hammertoe or foot surgery for hammertoes.
You will probably have to avoid shoes that squeeze your toes and high heels that put pressure on the toes causing hammertoe surgery pain. Hammertoe surgery should relieve the pain, discomfort, and cosmetic concerns.
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