Hammer, Claw or Mallet Toes

Tight shoes are the most common cause of these toe problems. Wearing tight shoes can cause the toe muscles to get out of balance. If a shoe forces a toe to stay in a bent position for too long, the muscles tighten and the tendons shorten, or contract. This makes it harder to straighten the toe. Over time, the toe muscles can't straighten the toe, even when you aren't wearing shoes.

These toe problems form over years and are common in adults. Women are affected more often than men because they are more likely to wear shoes with narrow toes or high heels.

Less often, these toe problems are linked with other conditions, such as diabetes, rheumatoid arthritis, stroke, or an injury to the foot or ankle.

Your doctor will ask questions about your symptoms and past health and do a physical exam. Your doctor will want to know:

• When the problems started, what activities or shoes make them worse, and if other parts of the foot are painful.
• What kind of shoes you wear and how much time you spend standing or walking every day.
• Any previous foot problems you have had.
• Any medical conditions you have that could be related, such as arthritis, diabetes, or poor blood flow (circulation).

During the physical exam, your doctor will look at your foot to see if the toe joint is fixed or flexible. A joint that has some movement can sometimes be straightened without surgery. A fixed joint often requires surgery.

If the doctor thinks you may need surgery to correct your problem, you may have tests, such as an X-ray, blood flow testing, or nerve testing.

You may need surgery if other treatments don't control your pain, if your toe limits activity, or if you can't move the toe joint (fixed toe problem). In general, surgery is used only for severe toe problems.

• For fixed toe problems, doctors often do surgery on the bones. One option is removing part of the toe bone. Another is removing part of the joint and letting the toe bones grow together.
• Flexible toe problems are often treated by moving tendons to release tension on the joint. This can let the toe straighten. In some cases, the surgery will still include work on the bones.

Surgery for these problems has not been widely studied, and it may not be for everyone. Talk to your doctor about your options and how much they might help you.