Shoes for hammertoes

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Foot problems are very common. Annually, in the United States, 43 million people have foot complaints and 15 million of them seek medical attention.

Hammertoes describe the down bending shape the toes take as they become deformed. The closer joint of the toe angles upward, while the end of the toe bends downward. Hammertoe occurs most commonly with the second toe, but any of the other smaller toes can also be affected.

Hammertoes occur when there is a muscle imbalance in the foot, which causes the end joint of one or more toes to bend down. The joints may become permanently fixed in this position. The basic problem that causes hammertoes is the abnormal spreading of the forefoot. Hammertoes can be hereditary or caused by a bunion, an abnormality in the nerves, high arches or a weakening of the arch muscles that control the base of the toe. Hammertoes can also be caused by shoes that do not fit properly or socks that cramp the toes. Hammertoes may occur with age. Since the tissues become less pliable with aging, the foot's normal arch may cause the toes to become bunched up in the shoe.

Pain caused by hammertoes can be relieved by stretching shoes or wearing wider shoes that have plenty of room in the toe area and in the ball of the foot. Custom footwear may be necessary. Avoid wearing tight, restrictive shoes, especially high-heeled shoes. Cushioned pads and insoles help to relieve pressure from shoes. Getting properly-fitting shoes may be the only treatment necessary during the early stages of bunions and hammertoes.

If a hammertoe still has movement, splints may be used to hold the toe in a straight position. If the condition becomes painful, surgery may become necessary. During bunion and hammertoe surgery, part of the toe bone is removed and the toe is realigned or straightened.

The best treatment is prevention. To avoid the development of hammertoes, follow these guidelines:

• When buying new shoes, try them on at the end of the day (since feet tend to swell during the day). Stand while your shoes are being fitted, and walk around the store to make sure the shoe fits.

• Feet may vary in size, so buy shoes that fit to the longer and wider foot.

• Don't pick shoes by size, since brands differ.

• If shoes feel too tight, don't buy them. Don't expect them to "stretch to fit."

• Wear properly fitted shoes; avoid very high-heeled, narrow shoes which push the toes forward.

• Wear shoes with a high toe box and increased width in the toe area.

• Remember that shoe size may change with age. Have your feet measured often.

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