Will My Hammertoe Require Surgery?
Jun 02, 2025
At South Texas Foot Surgeons, PA, in San Antonio and Kerrville, Texas, our expert team sees both early and advanced hammertoe deformities on a routine basis. We know how to assess hammertoe progression and decide whether you need conservative care or surgery to fix it.
Here, we explain what qualifies as a severe hammertoe, how we determine our treatment approach, and what to expect if you need foot surgery.
A hammertoe happens when one of your smaller toes, usually the second, third, or fourth, bends downward at the middle joint, much like an inverted “V” or a claw. It typically starts with a slight bend that gradually becomes stiff and in a fixed position. The joint becomes stuck, and the top of the toe rubs against the inside of your shoe.
Corns and calluses may form, and eventually, even walking can feel uncomfortable. Unlike a bunion, which affects the base of the big toe, or a mallet toe, which bends at the joint closest to the nail, a hammertoe bends in the center. It’s a distinct structural deformity that tends to worsen over time, especially without treatment.
The cause of a hammertoe is usually an imbalance in the muscles and tendons that support your toes. This can happen from wearing tight or ill-fitting shoes, especially high heels or shoes with narrow toe boxes. It can also develop from arthritis, foot injuries, or genetics.
Once there’s an imbalance around the middle toe joint, the affected toe begins to curl, or claw, downward. If it isn’t addressed, the deformity worsens over time.
Hammertoes range in severity. In the early stages, the toe is still flexible. That means you can press it flat with your hand, and it may only hurt occasionally. But once the joint becomes rigid, the toe stays in a bent position all the time, and there’s little chance of reversing its position without surgery.
If the joint won’t straighten on its own and it hurts to walk, the problem has probably progressed too far for correction via conservative care. Severe hammertoes are rigid, not flexible. They don’t respond to toe stretches or splints. They may also develop open sores where the bent toe rubs against the inside of your shoe.
Ball-of-foot pain may also occur, as your gait changes to compensate for the toe pain you feel. You may start avoiding certain shoes, changing how you walk, or limiting your physical activity altogether. The longer you wait to get help, the more damage you’re likely to sustain in the affected toe joint and tendons — and the more complex the surgery may become.
Yes, but only if it’s caught early. In mild or flexible hammertoe cases, non-surgical treatment can help relieve symptoms and stop, slow, or reverse deformity progression. This may include:
These treatment methods don’t simply ease hammertoe pain and keep the joint from stiffening further — with prompt application, they can sometimes reverse the deformity.
If the hammertoe is rigid, painful, and interfering with your usual activities, surgery is the most effective solution. The specific procedure depends on the toe’s position and the severity of its rigidity. Our team might:
Most procedures are done on an outpatient basis and take less than an hour. You’ll likely go home the same day in a surgical shoe, and recovery typically takes a few weeks. You’ll be able to bear weight fairly quickly, and most patients are back in normal shoes in four to six weeks.
A hammertoe that’s stuck, painful, or limiting your daily life likely won’t improve without surgery. At South Texas Foot Surgeons, PA, we offer expert care and effective treatment to help you get back on your feet quickly.
Whether you need conservative hammertoe management or surgery, we’ll get you back to walking comfortably again. Schedule an appointment with our experts at your nearest South Texas Foot Surgeons, PA, office in San Antonio or Kerrville, Texas, today.