A hammertoe is a deformity of one of the smaller toes in which the middle joint bends abnormally downward — causing the toe to resemble the shape of a hammer or claw. The second toe is most commonly affected, though the condition can develop in the third, fourth, or fifth toes as well.

Hammertoes develop in two stages. In the early, flexible stage, the affected toe can still be straightened by hand. This is the ideal time to seek treatment — conservative options are highly effective and surgery can often be avoided. In the later, rigid stage, the tendons and joint capsule have contracted and the deformity becomes fixed, making surgical correction the only option for permanent relief.

The condition causes pain on the top of the bent joint from shoe pressure, as well as at the tip of the toe from altered gait. Corns and calluses commonly develop at these pressure points and add to the discomfort. In more advanced cases, the toe may cross over or under an adjacent toe, creating additional pressure and skin problems.

Hammertoes are most often caused by muscle and tendon imbalance — frequently triggered by bunions pushing the big toe against the second, by abnormal foot mechanics, or by wearing shoes that crowd the toes over many years.