Q. Two of my toes are bent up in the middle and push against the tops of my shoes, which is causing foot pain when I walk and with some of my shoes. Why is this happening, and what can I do about it?

A. This sounds like the relatively common foot condition known as hammertoe, which is a progressive problem that can develop over time—often from wearing high-heeled shoes and shoes that are too small or narrow toward the front. These factors can jam the tips of your toes down and ultimately cause the middle joints on one or more of your toes to bulge or hump upward.

The tops of your toes can then rub against the tops of your shoes, which can lead to painful sores, corns, and calluses. In addition to foot pain, hammertoe can affect your gait as well. (A muscle imbalance or the muscle-weakening nerve damage that might be a complication of diabetes can also cause hammertoe.)

This most often develops in the second, third, and/or fourth toes. If you think you have hammertoe, see a podiatrist for confirmation. If it’s hammertoe, you will likely need to start wearing lower-heeled shoes with roomy toe boxes. The American Academy of Orthopaedic Surgeons recommends that shoes be a half-inch longer than your longest toe, for comfort.

Placing cushioned stick-on pads on the tops of hammertoes may prevent sores, corns, or calluses, from forming. Taping a hammertoe to the normal toe next to it (called “buddy taping”) with gauze or sports tape, or using orthotic straps and splints that can keep a hammertoe in its regular place can also help reduce discomfort.  If you are still uncomfortable, talk with your podiatrist about whether stretching and strengthening foot exercises—such as placing a towel on the floor and then picking it up with your toes—can help.

Be aware that hammertoes are usually flexible at first, but if left untreated, may become rigid over time. In some cases, hammertoe may require surgery. Several different outpatient procedures are used to correct hammertoe, depending on how severe the problem is, how many toes are involved, and whether other foot problems, such as bunions, are also present.  

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