Monday, June 14, 2010
ROCHESTER, Minn. — The pain from hammertoe, a deformity that can cause one or more toes to assume a claw shape, can curtail an evening of dancing or make a favorite pair of shoes unwearable. But, according to the June issue of Mayo Clinic Health Letter, this condition often can be managed by proper footwear or simple toe coverings.
In older adults, feet tend to get larger and wider. Some adults may not have adjusted their shoe sizes accordingly. Shoes that are too small, too tight in the toe box or have high heels are contributing causes to hammertoes. Other contributors can include toe injuries; rheumatoid arthritis; or nerve damage due to diabetes, arthritis or stroke.
For a while, a hammertoe may maintain some flexibility. But when a toe is forced into a bent position too long, the muscles and tendons that control the toe may tighten, resulting in a rigidly bent toe. The pain from a hammertoe is most commonly caused by the pressure and friction from pressing against the inside of the shoe. Calluses and corns, a hard growth of skin, can develop, worsening the pain.
Conservative treatments won't straighten the toe, but they can help ease the pain. Options include:
Shoe choice: Wearing shoes with a soft, roomy toe box and avoiding high heels will take the pressure off the hammertoe. Many shoe stores can stretch out a pressure point in an otherwise well-fitting shoe. Shoes made of soft leather or stretch fabric uppers that don't press on the toes are good options.
Special devices: Various pads or elastic splints can reposition or support the hammertoe so that the toe lies in a flatter position.
Treatment for corns: Wearing shoes that don't rub on a corn is often enough to allow it to gradually go away. Nonmedicated corn or callus pads or toe sheaths may help cushion the area. A doctor can pare down a large corn or callus with a surgical instrument.
When conservative measures fail, surgical correction is an option. Lengthening a tight tendon or other soft tissues in the toe may be enough to allow the toe to lie flat. Surgery usually is an outpatient procedure and often successfully straightens the toe, though rigidity may remain. Mayo Clinic surgeons don't recommend hammertoe surgery for cosmetic purposes alone as there is always some risk of infection or complication, such as a toe that flails loosely or becomes misaligned.
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