Most Jamaicans spend a lot of time in open-toed shoes. We are very aware of the appearance of our feet and how attractive they look, however hammer toes can spoil that and cause pain and discomfort.

Hammer toe deformity is one where the proximal toe joint is permanently bent. It can occur on the second, third or fourth toes and is due to an imbalance in the muscles, tendons and ligaments that normally hold the toe straight.There are two types of hammer toe:1. Flexible: Flexible hammer toes are those where the toe can still be moved at the joint. This is a less severe form of the problem.2. Rigid: Rigid hammer toes are those where the tendon in the toe becomes stiff and presses the joint out of alignment.The most common cause of this deformity is poorly fitting shoes that force the toe into a bent position. Shoes that are very high, narrow, or too small are the main culprits. Other causes include trauma, arthritis, and genetics.

SymptomsThe affected toe will often rub against the top of shoes and cause a corn, callous or bursitis to develop. The toe may be stiff and swollen, and there may also be pain in the ball of the foot underneath the bent toe. 

Treatment and prevention1. Wear shoes that have broad, deep toes or are open-toed, to reduce pressure.2. Make sure there is at least a one-centimetre gap between your longest toe and the end of your shoe.3. Don’t wear shoes higher than five centimetres.4. Wear non-medicated toe cushions to ease the discomfort and pressure.5. Exercise the toes by stretching the muscles and loosening the tendons. Try picking up items from the floor with your toes.6. If the pain is acute, your podiatrist may give you a cortisone injection to reduce the inflammation. Your podiatrist may also be able to make you an orthotic device to wear in your shoe to protect the toe.7. Corns should be removed by your podiatrist. Do not use over-the-counter corn removers as these often make the problem worse.8. In severe cases, surgical intervention may be necessary. 

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.