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Hammer Toes

Q: I live in high heels and have never had a problem because of it, until recently. A few months ago I noticed that my left middle toe started looking bent and now it's starting to cause me quite a bit of pain. Because it's so buckled, it's hard to put on shoes without them rubbing against my toe and causing even more discomfort. What's going on and what can I do?

Dr. Donnica:
To begin with, you need to start wearing more comfortable shoes! It sounds like you have a condition called "hammer toe." This is a toe that is contracted at the middle joint which can cause severe pressure and pain. As you've experienced, this in turn causes it to rub against the shoe, exacerbating the pain. Movement of the toe may also be painful and limited. Hammer toe can affect any toe except the big one.

Hammer toes result from a muscle imbalance that causes the ligaments and tendons to become unnaturally tight which then curve the affected joint downward. In your case the problem is probably caused by your footwear, but arthritis may also be a cause.

To manage your pain, start by switching to shoes in which the toe box (toe area) is high and broad and can accommodate the hammer toe. You may want to take an over-the-counter pain reliever such as ibuprofen so long as you're not allergic to aspirin. In addition, there are several products designed for the conservative management of hammer toes, such as hammer toe crests and hammer toe splints. These devices help hold down the hammer toe and provide relief to the forefoot.

Gel toe shields and gel toe caps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication. A good source for these products is www.foot.com. If the pain persists after you've made these changes, you should consult a podiatrist (foot doctor) or an orthopedic surgeon.

Created: 9/14/2004  -  Donnica Moore, M.D.

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