Hammertoes are very common in the general population. Hammertoes can either be flexible, semi-flexible or rigid (stuck) in a continually flexed or contracted position. They can be painful or just unsightly without pain. They can make it very difficult to wear certain shoes. Hammertoes occur due to a genetic predisposition to this condition and are oftentimes inherited. Ill-fitting shoes do not cause you to have hammertoes rather they will contribute to the deformity. Narrow shoes will hurt the feet of someone with hammertoes and make the condition that was already present worse and symptomatic.
I had a pleasant, non-diabetic lady in her late nineties; yes 90s, who presented to me with a recurrent, painful ulcer at the tip of her right third toe underneath the toenail. She actually had hammertoes with this particular toe more contracted or rigid than the others allowing for more weight on the tip of this particular toe. She initially was wearing flat, narrow non-supportive shoes. Even with weekly wound care and wearing a special surgical shoe to take the pressure off of it, it still was not healing. This toe was very stubborn. Finally, the wound did heal after a straightening procedure of the toe called an arthroplasty. This surgery was certainly not for cosmetic reasons rather it was for functional, practical reasons.
Hammertoes can also be so severe as to cause tears of the surrounding ligaments of the joint in the ball of the feet. The excessive forces in the toe caused by the hammertoe can lead to a condition called a plantar plate tear that can only be treated with a surgical procedure to repair the tear. This plantar plate or ligament in the ball of the foot is very important in terms of balancing the toe properly and it keeps the toe straight. This plantar plate injury can be very painful especially in very active people such as runners, athletes, busy mothers, and workers standing all day. Surgical repair of this condition will take away pain and restore function as well as straighten the toe.
If you have a painful toe that not only looks bad but feels bad, then surgical repair is a long-term solution to this condition. Otherwise, without surgery, the toe will not straighten out by itself. Without surgery, treatment would consist of padding, wide shoes, functional orthotic devices and cortisone injections. Either way, there is relief for this condition. Contact your local podiatric foot and ankle surgeon for an evaluation and treatment options for this condition.