How Cortisone Injections Can Help Your Hammertoes

A hammertoe is a deformity of the second, third, and/or fourth toes on either foot. The toe bends at the middle, or proximal interphalangeal (PIP), joint, so the whole toe takes on a hammer-like appearance. 

Hammertoes can be flexible, which are easily correctable, or rigid, which require surgery.

At Chicagoland Foot and Ankle, our board-certified foot and ankle surgeons understand how uncomfortable hammertoes can be, which is why we offer a variety of nonsurgical and surgical options to treat them. 

We also want to educate our patients about conditions such as hammertoes, so we’ve put together this guide to get you in the know.

What causes hammertoes?

Hammertoes develop because of the toe muscles, which work in pairs to flex and extend each toe. When the muscles get out of balance, it puts pressure on the tendons and joints, pulling and pushing them into a hammertoe formation. 

If the toe remains in one position long enough, it can become rigid, preventing the toe from straightening.

Causes include:

• Shoes with small toe boxes
• High-heeled shoes, especially pointy-toed ones
• Genetics
• Arthritis
• High arches
• Flat feet
• Feet that rotate inward when you walk
• Long toe bones
• Bunions
• Extremely tight tendons

Women are more likely than men to get hammertoes because of the kinds of shoes they wear.

Hammertoe symptoms

Shoes that narrow at the front squish the toes together until the pressure forces the middle three toes into a flexed (bent) position. 

Bunions on the big toe (and tailor’s bunions on the pinky toe) push against the toes next to them, sometimes moving under the adjacent toe so that it has to bend at the PIP joint to accommodate the pressure from below.

While you may not experience any symptoms other than the bending, it’s quite common for the hammertoe to be painful, both at the bent joint and around the ball of your foot.

Other symptoms include restricted joint motion, redness or swelling around joint (inflammation), blisters, corns, and calluses where joint rubs against the top of shoes, and difficulty walking.

Symptoms can vary from mild to severe, depending on how flexible the hammertoe joint is.

Hammertoe treatments

In most cases, no matter whether your hammertoe is flexible or rigid, we can treat it successfully. If you have a mild case and your joint is still flexible, we start with conservative treatments, including:

• Shoes with larger toe boxes
• Shoes with added depth
• Orthotics (shoe inserts)
• Physical therapy (toe muscle stretches)
• Over-the-counter anti-inflammatory medication

We also might administer cortisone injections. Cortisone is a steroid that, when injected into the affected joint, can reduce the inflammation and related swelling, decreasing your pain and discomfort. 

This is a short-term solution, but it may buy you enough time to master stretching exercises and get proper shoes so that the joint no longer bothers you.

If you have a rigid hammertoe with a great deal of pain or you have an open sore on the top of the toe from rubbing against the shoe, we may recommend a surgical option. Common procedures include:

• Arthroplasty to remove half of the joint under each bent toe so it can lie flat
• Arthrodesis to remove the whole joint under each bent toe and insert a wire to straighten the toe as it heals
• Tendon transfer to move tendons from under the toe to the top of the toe to help straighten it out

If you’re dealing with the pain and associated symptoms of hammertoe and need relief, it’s time to come into Chicagoland Foot and Ankle for a consultation. 

Contact us for an appointment at one of our locations in the Mount Greenwood and Portage Park areas of Chicago, as well as in Orland Park and New Lenox, Illinois.