Could Neuropathy Cause Hammertoes

Overview

Hammer toes are usually not a serious condition, but can become painful as the bent joint rubs against the inside of the shoe, causing irritation, corns, or calluses on the top of the middle joint or the tip of the toe. A Hammer toe may also cause occasional shooting pains throughout the toes or elsewhere in the foot. A hammertoe has a kink or contracture in its second joint--called the proximal interphalangeal joint--that causes the toe to bend upward in the middle, giving it a hammer-like appearance. The raised part of the toe often rubs on shoes, leading to the formation of corns or calluses. Usually hammertoe affects the smaller toes, causing pain and interfering with the ability to walk normally.

Causes

Some causes of hammertoe are shoes that are too tight or short, shoes with high heels, injury, Diseases that affect the nerves and muscles, such as arthritis and diabetes. When shoes do not fit well, over time the pressure of the shoes pushes the toes into a bent position. After a while, the muscles become unable to straighten the toe, even when you are not wearing shoes. Similarly, when there is damage or disease of the nerves or muscles in the toes, the toe may rest in the bent position until the tendons become permanently shortened and the toe becomes a rigid hammertoe. The risk of developing a hammertoe increases with age. Women are much more likely to develop a hammertoe than men.

Symptoms

A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Non Surgical Treatment

Padding and Taping. Often this is the first step in a treatment plan. Padding the hammertoe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain. Medication. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity. Orthotic Devices. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe Hammer toes deformity.

Surgical Treatment

If these non-invasive treatments don?t work, or if the joint is rigid, a doctor?s only recourse may be to perform surgery. During the surgery, the doctor makes an incision and cuts the tendon to release it or moves the tendon away from or around the joint. Sometimes part of the joint needs to be removed or the joint needs to be fused. Each surgery is different in terms of what is needed to treat the hammertoe. Normally after any foot surgery, patients use a surgical shoe for four to six weeks, but often the recovery from hammertoe surgery is more rapid than that. An unfortunate reality is that hammertoe can actually return even after surgery if a patient continues to make choices that will aggravate the situation. Though doctors usually explain pretty clearly what needs to be done to avoid this.

Prevention

Walking barefoot increases the risk for injury and infection. Being on your feet throughout the day can cause them to swell, this is the best time to buy shoes to get a better fit. Do not buy shoes that feel tight. Do not buy shoes that ride up and down your heel as you walk. The ball of your foot should fit into the widest part of the shoe. Remember, the higher the heel the less safe the shoe will be. Avoid shoes with pointed or narrow toes. If the shoes hurt, do not wear them. If you start noticing the beginning signs of hammer toes, you may still be able to prevent the tendons from tightening by soaking your feet every day in warm water, wearing toe friendly shoes, and performing foot exercises such as stretching your toes and ankles. A simple exercise such as placing a small towel on the floor and then picking it up using only your toes can help to restore the flexibility of tendons.