3 Reasons Hammertoes Can Progress — and What Treatments May Help
Oct 14, 2026
/assets/images/provider/photos/2864360.jpeg)
If you notice one of your smaller toes starting to bend upward at the middle joint, you might be dealing with a hammertoe. At Southwest Foot & Ankle Center, our board-certified podiatrists, Petrina C. Lewis, DPM, FACFAS, and Mark T. Lewis, DPM, FACFAS, help patients find relief from this common condition. We serve communities across multiple locations, including Scottsdale, Arizona, as well as Renton, Redmond, Puyallup, and Everett, Washington.
A hammertoe is a progressive deformity, meaning it tends to get worse over time if left untreated. What starts as a mild, flexible bend can eventually lead to chronic foot pain and permanent stiffness. Understanding why this progression happens is the first step toward protecting your mobility.
Hammertoes progress because of ongoing muscle imbalances, joint stiffness, and external pressure. When you leave a hammertoe untreated, the structural changes in your foot naturally accelerate. This condition gets worse for three main reasons:
A hammertoe is primarily a neuromuscular issue, not just a cosmetic problem. The stronger extrinsic muscles in your foot pull against the weaker intrinsic muscles, causing the toe to bend. Over time, this constant pulling forces the toe further out of alignment.
In the early stages, your toe joint is still flexible, meaning you can manually flatten it. However, if you don't address the imbalance, the joint capsule and surrounding tissues permanently contract. Once this happens, the toe becomes rigid and locked in a bent position.
While narrow shoes are rarely the sole cause of a hammertoe, they act as a major catalyst. Wearing shoes with a tight toe box squeezes your toes together, which speeds up the joint contracture and causes painful friction.
The right treatment for a hammertoe depends entirely on whether your joint is still flexible or has become rigid. We match the therapy to your specific stage of progression to get you back on your feet comfortably.
If your toe is still flexible, conservative care is highly effective. We often recommend custom orthotics to redistribute pressure and stabilize your foot's biomechanics. Combining these with wider footwear and silicone padding can stop the deformity from worsening.
For rigid hammertoes or severe complications, advanced interventions are necessary. If you suffer from diabetic neuropathy, a progressive hammertoe can lead to dangerous ulcers that require specialized wound care.
In these high-risk cases, a minimally invasive procedure called a percutaneous needle flexor tenotomy can help. In fact, a 2022 clinical study found that this quick tendon release achieved a 100% ulcer healing rate compared to just 37.5% with standard non-surgical care.
You cannot permanently reverse a rigid hammertoe without surgery, although conservative treatments are excellent for managing your symptoms.
Specifically, while over-the-counter devices and orthotics reduce friction and pain, they cannot change the bone structure. It is also a common misconception that splints or toe separators can cure the underlying structural bend. Once the joint becomes rigid, surgical realignment is the only way to restore a straight, natural position.
If you're tired of dealing with toe pain or are worried your condition is worsening, we're here to help. Please contact our team today to schedule a consultation at one of our convenient offices in Arizona or Washington.