High-heeled, peep-toe pumps and foot skimming Italian loafers: what do they have in common? Aside from being stylish and fun to wear, when worn regularly these two types of shoes can cause a very painful deformity of the bones in the foot called hammer toe. Here’s how shoes for hammer toe can help, along with other interventional treatment approaches.
What causes hammer toe?
Hammer toe is when an outside force (generally shoes) causes your toes to bend toward each other or down toward the ball of your foot. The joints most often affected are those that lie closest to the rest of the foot, and the second, third, and fourth toes are most often involved. This condition changes the underlying bone structure of each toe at the joint and can make walking very painful.
Improper footwear most often causes hammer toe.
Shoes that compress the toes across the ball of the foot are a big culprit in the development of this condition, especially if those shoes are heels above one-inch. Over time, this compression can cause the bones of the toes to cross over each another, causing deformity and, more often than not, pain.
Two genetic diseases that cause deformity in bone structure can also cause hammer toe. Charcot-Marie-Tooth disease or Friedrich’s ataxia can affect muscle structure in the foot. This can cause misalignment of the bones of not just the toes but also of the entire foot.
People suffering from arthritis can also develop hammer toe, although the pain is generally thought to be caused by the arthritis in this case and not the hammer toe. Nerve damage from stroke or diabetes may also cause pain in the toe joints, although not necessarily hammer toe.
How to wear shoes for hammer toe
Thankfully, a very simple beginning hammer toe treatment costs nothing and is easy for everyone to access: stop wearing narrow high heels.
This alone will often help with the pain of hammer toe and also allow the joints to move back to their proper place. Only pursuing this treatment option will take more time to reverse the damage. In some cases, the damage is so severe that further treatment is necessary. At the very least, though, ditching the constricting shoes starts the process of recovery and may be enough to relieve symptoms.
If you must wear three-inch stilettos, wear comfortable shoes until you get where you are going, then swap them out. Give your feet plenty of rest when you can (remove the shoes when seated) and flex your toes when you take your shoes off to stretch them out and give them room. It is best to try on shoes in the morning for proper fit, but do keep in mind that feet tend to swell and are larger at the end of the day. In this case, keep a pair of comfortable shoes for the drive (or walk) home, and your feet will thank you.
What are the best shoes for hammer toe?
A pretty high-heeled shoe may complete your outfit, but wearing shoes that force your toes to bend toward each other (or down toward the ball of your foot) can result in a painful condition called hammer toe. This condition changes the underlying bone structure of each toe at the joint and can make walking very painful. Choosing the right shoes (and wearing the wrong ones judiciously!) can help to avoid developing this condition.
When shoe shopping, look for shoes with lots of room in the toe area and strong arch support.
You should also avoid shoes that are too narrow or perch you up on the very balls of your feet. This does not mean eliminating all types of high-heeled shoes forever. Look for shoes with heels that are no more than one and a half inches tall. Also look for shoes that are wider around the balls of the feet. Kitten heels with open toes are fashionable and provide potentially more support than those three-inch stilettos.
There are also plenty of orthotic insoles that can help provide arch support if you need it, from insoles that use gel to cushion the arch and heel to simple pads. A podiatrist can guide you, or you can try insoles on for size to see which offer the most comfort and support. Your regular doctor may be able to help you before you see a specialist, so if you are experiencing foot pain, don’t hesitate to ask for guidance.
What are hammer toe treatments?
People looking for hammer toe treatment have several options for pain relief that go beyond over-the-counter (OTC) or prescription medications. For some cases of hammer toe, the use of compression socks that help support the ball of the foot while separating the toes can offer pain relief and therapeutic benefits. Custom fit orthotic inserts can also help with support for the whole foot.
Hammer toe exercises
There are also exercises that can help with hammer toe.
Toe crunches work your arch and your toes much like an abdominal crunch would. Take your socks and shoes off and sit comfortably in a chair with your feet on the ground. Place a rolled up towel under the ball of the affected foot. Curl your toes down to grab the towel and squeeze. Release. Repeat this exercise ten times (or as many as you can, working up to ten).
Tapping your toes also helps. Sit in the same position as before. Extend your big toe up and then tap the floor with the other toes. Reverse (big toe taps, other toes point up), and repeat ten times.
Physical therapy can also help in some cases. Sometimes doctors can also simply splint the affected toes to each other, modifying the splint as the bone begins to normalize in the toe.
If pain is persistent and chronic, doctors may opt to administer a spinal nerve block. This is when the pain-signaling nerves for the feet are blocked at the spine using lidocaine to prevent them from sending pain signals to receptors in the brain and steroids to control inflammation. For cases in which patients are completely immobile due to pain from hammer toe, this is a quick way to offer immediate, long-lasting relief while they undergo physical therapy.
While a spinal nerve block gives several weeks of pain relief, radiofrequency ablation (RFA) can offer months of pain relief. Nerves are targeted in much the same way as a nerve block, but in RFA, the nerve responsible for pain signals is destroyed with electro-thermal impulses.
Another method of pain relief is called spinal cord stimulation (SCS) where needle-thin wires are implanted along the spinal cord near the affected nerve. Electrical impulses disrupt the pain signals from the nerve. These impulses can be controlled by the patient and can offer several months of pain relief.
In cases where surgery is necessary, advances in surgical techniques mean shorter recovery times and less chance of complications or infections. For less severe hammer toe, surgeons may remove a small piece of bone and realign the toe, but in more severe cases surgery is more complicated. If you do have to have surgery, make sure you’ve attempted all other treatments first.
Continuing to exercise your feet and wearing proper footwear are advised after surgery. There are more choices now for supportive shoes for hammer toe, but it is important to choose carefully.
There are potential complications from all of these treatments, ranging in severity from numbness at the insertion or injection sites to infection and an increased risk of arthritis or weight gain as a result of steroid use. Patients will have to weigh the risks versus the benefits of each treatment and decide with their doctors if any of the above are effective options.
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