Hammertoes You Shouldn't Keep Putting Off: When Surgery May Be an Option

Ask someone who has lived with a hammertoe for a few years to open their closet, and the closet usually tells the story. Dress shoes with a shiny worn spot right over one toe. Sneakers with a slit cut in the top "just for a little more room." A drawer full of toe pads, sleeves, and cushions that each worked for about a week.

People are remarkably good at working around toe pain. They switch shoes, skip the long walk, and decide it's just something they live with now.

Sometimes that's a reasonable choice. But hammertoes are one of the foot problems most likely to change quietly underneath all those workarounds. So before anyone talks about scheduling surgery, there's a more important question to answer: how do you know when a hammertoe needs more than padding?

What a Hammertoe Is, and Its Close Cousins

A hammertoe bends upward at the middle joint, so the toe takes on an upside-down V shape. It most often affects the second, third, or fourth toe. The raised knuckle rubs against the top of your shoe, which is why painful corns so often form there.

Two related problems are worth knowing by name. A claw toe bends at both the middle and end joints, curling the tip down toward the ground. A mallet toe bends only at the joint closest to the nail, which can cause a sore tip or a thickened, damaged nail. All three are evaluated and treated in similar ways.

Why Hammertoes Rarely Stay the Same

A hammertoe develops when the muscles and tendons that hold the toe straight fall out of balance. Narrow or pointed shoes, high heels, a bunion crowding the toes, foot structure you inherited, arthritis, and some nerve conditions can all contribute.

Once that imbalance takes hold, the toe usually doesn't straighten itself. Early on, a hammertoe is typically flexible. Over months or years, the tissues around the joint tighten, and the toe can stiffen into a fixed bend.

That change matters because flexible hammertoes are often simpler to correct than rigid ones.

Try a Quick Flexibility Check

Sit down, take off your shoe and sock, and gently try to straighten the bent toe with your fingers.

If it straightens fairly easily, the toe is likely still flexible. If it straightens only partway, or won't move at all, it may be semi-rigid or rigid.

This isn't a diagnosis, and you shouldn't force a toe that hurts. But it's a useful thing to notice, and it's one of the first things Dr. Bembynista checks during an exam.

What Non-Surgical Care Can and Can't Do

Conservative care helps many people with hammertoes, especially when the toe is still flexible. Options include:

Shoes with a deep, roomy toe box so the bent knuckle isn't pressed against the top of the shoe.

Pads, sleeves, and splints that cushion the knuckle or gently hold the toe in a better position.

Custom orthotics that improve how pressure moves across the foot.

Professional corn and callus care to relieve painful buildup safely.

These treatments can make a real difference in comfort. What they can't do is permanently straighten a toe or reverse the tendon imbalance underneath.

One important caution: if you have diabetes or circulation problems, avoid over-the-counter acid corn removers. They can damage healthy skin around the corn and lead to a serious infection.

Signs It May Be Time to Talk About Surgery

Surgery is usually considered when a hammertoe keeps causing pain or limiting what you can do, even after reasonable non-surgical care. Signs worth paying attention to include:

Your shoe choices keep shrinking. You've run out of shoes that don't press on the toe, even in wider sizes.

The corn keeps coming back. You've trimmed, padded, and treated the same corn over and over, and it returns every time.

The toe has stiffened. A toe that used to straighten with your fingers no longer does.

Your skin is breaking down. Blisters, open sores, or a red, irritated knuckle need prompt attention, especially if you have diabetes or poor circulation.

Pain has moved to the ball of your foot. A bent toe can push its base down into the ball of the foot, causing pain there as well.

You're avoiding things you enjoy. Walking the neighborhood, playing pickleball, or standing through a full Chiefs tailgate has become something you plan around.

Problems That Often Travel With Hammertoes

Hammertoes rarely show up alone, which is one reason a thorough evaluation matters.

Bunions are the most common companion. As the big toe drifts toward the second toe, it can crowd that toe upward into a hammertoe. If a bunion is part of the picture, it needs to be considered in the treatment plan.

Ball-of-foot pain often develops under a hammertoe as pressure shifts forward.

Corns and calluses form on top of the knuckle, at the tip of the toe, or on the ball of the foot.

Nerve pain in the ball of the foot, such as a Morton's neuroma, can feel similar to hammertoe-related pain. Burning, tingling, or the sensation of stepping on a pebble suggests a nerve may be involved.

What Happens If You Wait?

For some patients, waiting is fine. A mild, flexible hammertoe that doesn't hurt may be managed comfortably with good shoes for a long time.

For others, waiting has a cost. A flexible toe may become rigid, which can mean a more involved correction later. Corns and pressure sores can become more frequent. And the way you walk can change to protect the toe, sometimes creating new pain elsewhere in the foot.
The cost of waiting isn't the same for everyone, which is why an exam is worth more than a guess.

What Hammertoe Surgery Can Look Like Today

Many patients picture a large incision and a pin sticking out of their toe for weeks. That isn't always how it works anymore.

For many patients, Dr. Bembynista uses a minimally invasive technique guided by real-time X-ray, correcting the toe through a very small incision. Some toes need only a release and rebalancing of the tendons and joint, while others need the bone itself realigned. All of his procedures are performed at a local outpatient facility, so patients typically go home the same day.

As with any surgery, hammertoe correction carries risks, including swelling, stiffness, infection, and the chance that the toe bends again over time. Your surgeon should walk you through what's realistic for your toe.

If surgery is the right path, our companion planning guide covers timing, costs, recovery, and what to set up at home.
Learn more about hammertoe treatment.

Hammertoe Care That Stays With One Doctor

If you've been told to just live with it, or you've been living with it on your own, KC Foot Care offers something many patients haven't experienced before: time and attention from the doctor himself.

Same-day visits and treatment mean you can often be seen quickly and start getting relief at your first appointment.

More time with Dr. Bembynista means a real conversation about your toe, your X-rays, and your options, without feeling rushed.

Comprehensive care means your whole foot gets looked at, including the bunion, corns, or ball-of-foot pain that often come with a hammertoe.

Personal availability and follow-up care right away mean that if you do have surgery, the surgeon who performed it is the one checking your progress and answering your questions.

Dr. Thomas F. Bembynista, DPM, is board certified by the American Board of Podiatric Surgery and has cared for patients in the Kansas City area for more than three decades, and with him your care includes a thorough evaluation, personalized follow-up with phone calls and text messages, and ongoing availability for your post-surgical needs.

Frequently Asked Questions About Hammertoes and Surgery

Do hammertoes get worse over time?

Often, yes. Hammertoes tend to stiffen gradually, moving from flexible to rigid. The pace varies widely, which is why monitoring a hammertoe is better than assuming it will stay the same.

Can a hammertoe be fixed without surgery?

Shoes with a roomy toe box, pads, splints, and orthotics can relieve pain, especially when the toe is still flexible. They don't permanently straighten the toe. If pain continues despite these measures, surgery may be an option.

Is hammertoe surgery painful?

Most patients experience some discomfort and swelling in the first several days, which is usually managed with elevation, rest, and medication as directed. Every patient's experience is different, and your surgeon will give you a plan for managing pain at home.

Can a hammertoe come back after surgery?

It can, although many patients have lasting results. Addressing contributing factors, such as a bunion or poorly fitting shoes, helps lower the chance of the toe bending again.

Should a bunion and hammertoe be fixed at the same time?

Sometimes. If a bunion is crowding the second toe, correcting only the hammertoe may not hold up over time. Your surgeon can explain whether treating both makes sense for your foot.
Find Out Where Your Hammertoe Is Headed

You don't need to decide on surgery to schedule an evaluation. You only need to want a clear answer about what's going on with your toe and what your options are. If surgery does make sense and you'd like to have it before the new year, Dr. Bembynista is still scheduling procedures for 2026. End-of-year surgical calendars fill quickly, so an evaluation in November leaves the most room to plan.

Get answers before another year of working around a painful toe.

Schedule an Appointment With KC Foot Care

Or call our Overland Park office at (913) 894-0660 or our Kansas City North office at (816) 455-3636.