Hammer Toes and Bunions: Causes, Symptoms & Treatment

Hammer Toes and Bunions are a common and often painful foot deformity that can make wearing shoes a daily struggle. Most often affecting the first and second toe, this condition causes one or more toes to bend upwards at the middle joint, leading to discomfort, friction, and sometimes corns or calluses.

One major contributing factor? You guessed it—bunions. In this guide, we’ll explore what causes hammer toes, the link between bunions and hammer toes, possible complications, and how to treat them—both at home and with professional help.

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What Are Hammer Toes?

A hammer toe occurs when the toe becomes stuck in a bent position at the proximal interphalangeal joint (the first joint after the toe base). This can lead to rubbing against the inside of your shoes, resulting in pain, inflammation, and thickened skin.

While the second toe is most commonly affected, hammer toe can also develop in the third and fourth toes.

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What Causes Hammer Toes?

There are several factors that can contribute to the development of hammer toes, including:

• Poorly fitting footwear

• A bunion on the big toe

• Arthritis (such as osteoarthritis, rheumatoid arthritis, or psoriatic arthritis)

• Neurological issues, including stroke

1. Ill-Fitting Footwear

Shoes that are too tight, pointy, or high-heeled often push the toes into unnatural positions. Over time, this pressure can force the toes to remain bent even when the shoe is removed.

• Tight shoes crowd the toes and push them upward.

• Pointed styles compress the toes inward.

• High heels shift body weight forward, increasing pressure on the forefoot and toes.

2. Bunions and Hammer Toes: The Connection

Bunions—a bony bump at the base of the big toe—can actually cause hammer toes to form, particularly in the second toe. As the bunion worsens, it can angle the big toe inward, forcing the second toe out of alignment and into a bent position.

If left untreated, both the bunion and the resulting hammer toe may require surgical correction.

3. Arthritis

Inflammatory conditions like rheumatoid arthritis can target the small joints in the foot, causing pain and misalignment. Osteoarthritis can also degrade these joints over time, leading to permanent toe deformities.

4. Stroke or Neuromuscular Conditions

After a stroke, muscle imbalances in the foot and leg may cause certain toes to flex and remain in that position. Without early intervention, this flexed state may become permanent.

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Complications of Hammer Toes

Once the toe becomes fixed in a bent position, the joint may become rigid and painful—especially when wearing shoes.

Common issues include:

• Friction and irrit

  

  ation at the top of the toe

• Corns and calluses developing from pressure and rubbing

• Skin breakdown, potentially leading to ulcers (particularly dangerous for people with diabetes or vascular disease)

• Calluses under the ball of the foot, due to increased forefoot pressure

Ulcers, if left untreated, can become infected and may take months to heal. They should be considered a medical priority, especially in patients with existing health conditions.

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What You Can Do at Home

Some simple measures can reduce symptoms or even prevent hammer toes from developing:

✅ Footwear Tips:

• Stick with shoes that have a wide toe box and low heels (no more than 2.5cm or 1 inch)

• Choose a shoe shape that mirrors the natural shape of your foot

• Get properly fitted using a Brannock Device, and walk around before purchasing

✅ Toe Strapping

Taping or strapping techniques can help realign the toe if the deformity is still flexible. This is best done under guidance from a podiatrist initially, but some patients can manage it themselves.

✅ Protective Padding

Using toe sleeves or gel guards inside your shoes can reduce rubbing and pressure.

✅ Night Splints

These can gently stretch the toe while you sleep, helping maintain mobility.

✅ Stretching Exercises

Daily stretching of the toes, calves, and foot muscles may improve flexibility and slow down progression.

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How Can a Podiatrist Help?

If home treatments aren’t enough, professional podiatric care offers several non-surgical solutions to manage hammer toes:

• Footwear advice tailored to your condition. To learn more about good shoes for people with diabetes click here.

  

• Custom orthotics to redistribute pressure across the foot

• Corns and callus removal using sterile instruments

• Anti-inflammatory medications for pain relief

• Bracing or splints for toe alignment

It’s important to note that conservative treatments can relieve symptoms, but they won’t reverse the deformity once it becomes rigid.

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Surgical Options for Hammer Toes

If conservative care is no longer effective and the toe is fixed in position, your podiatrist may refer you for surgery. Procedures may involve:

• Releasing or lengthening tendons

• Joint fusion

• Correction of an associated bunion (often necessary to prevent recurrence)

Surgical outcomes are generally positive, especially when followed by proper footwear and aftercare.

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Final Thoughts: Don’t Ignore Hammer Toes Caused by Bunions

If you’ve developed hammer toes due to bunions or other underlying issues, early intervention is key. The longer the toe stays in a bent position, the harder it becomes to correct without surgery.

Need help managing hammer toes and bunions? Book an appointment with our experienced podiatrists today and take the first step toward pain-free feet.