Short answer: Hammer toes and heel bumps are different problems with one thing in common: shoes rub them. Roomier footwear, padding and heel or toe supports settle many cases. Hammer toes that have stiffened and heel lumps that stay painful despite good care may need specialist assessment, and sometimes surgery.

If you've got a bent little toe with a corn on top, or a hard lump at the back of your heel that shoes catch on, you're in familiar territory. Both problems start quietly and get worse when footwear keeps rubbing the same spot. This guide explains what's going on in each, and how to decide what to try first.

What a Hammer Toe Actually Is

A hammer toe is a toe that's bent at its middle joint, usually the second, third or fourth. The tendons that hold it straight and the ones that bend it fall out of balance, and the joint gets pulled into a bend. Tight or short shoes make it worse, and it often appears alongside a bunion that crowds the neighbouring toe. Estimates suggest anywhere from 2% to 20% of people develop one (NHS Lothian, 2020), which reflects how many cases go unreported.

The key question is whether the toe still moves. If you can press it straight, it's flexible. If it won't budge, it's fixed. That difference drives most decisions.

Sorting Out Treatment for a Hammer Toe

For a toe that still straightens, the everyday treatment for hammer toe is mostly about taking pressure off and keeping the joint mobile:

• Choose shoes with a deep, wide toe box and roughly a thumb's width of space beyond your longest toe

• Use gel sleeves or a crest pad to cushion the top of the bent joint

• Try a splint or strap that holds the toe straighter during the day

• Practise gentle toe stretches and picking up small objects with your toes

If the toe has stiffened, the same measures can ease rubbing, but only surgery changes the shape. In practice, treatment for a hammer toe that's become rigid may involve releasing tight tendons, removing a small piece of bone, or fusing the joint straight, and there's good evidence for percutaneous, small-incision techniques as an alternative to open surgery (Reaney et al, 2024). Published outcomes put a good result at about 80% (NHS Lothian, 2022), so it's a sensible operation, not a guarantee. Swelling can linger for a few months after any toe surgery.

The Hard Lump at the Back of the Heel

The bump behind the heel gets nicknamed a "pump bump" because stiff back-of-shoe edges rub it. The medical name is Haglund's deformity, a bony enlargement at the back of the heel bone. It can inflame a small fluid sac beside it and irritate the Achilles tendon where it attaches.

Common contributors include a stiff heel counter, high arches, tight calves and a family tendency. It's often worst in court shoes, ice skates, hiking boots and any shoe that presses on the back of the heel.

What Helps a Heel Bump

Starting heel bumps treatment at home usually means removing the friction and unloading the tendon:

1. Switch to backless, open-back or soft-heeled shoes for a while.

2. Add a small heel lift, which tilts the heel away from the back of the shoe.

3. Use a donut-style pad or gel cup to cushion the bump.

4. Stretch the calf gently and keep the ankle mobile.

5. Ice and short-term anti-inflammatories can settle a flare, if you can safely take them.

Physiotherapy can help with calf tightness and Achilles loading. Steroid injections near the Achilles are generally treated with caution because of the risk of weakening the tendon, so it's worth discussing that with a specialist first. If months of sensible care don't calm it, surgery can be considered, usually to remove the prominent bone and clean up any irritated tissue. A weight-bearing X-ray helps plan it.

Comparing the Two

Shoe-Fit Habits Worth Adopting

• Have your feet measured standing, and check both feet, since they're rarely identical.

• Try shoes late in the day.

• Press the toe box and heel counter with your thumb. Very stiff heel counters can be trouble for heel bumps.

• Replace worn-out trainers before the cushioning collapses.

• Don't ignore skin that's broken, dark or very red, and see someone quickly if you have diabetes or reduced sensation.

Frequently Asked Questions

Can a hammer toe correct itself? Not once the shape has set, though a flexible toe can be kept comfortable for years with the right shoes and supports.

Do toe splints fix a hammer toe? They can ease symptoms and help a flexible toe, but they don't reverse a fixed one.

Is hammer toe surgery painful? Most people manage the discomfort with standard painkillers, and swelling and stiffness tend to be more noticeable than pain.

What causes a bump at the back of the heel? A bony enlargement called Haglund's deformity, often aggravated by stiff shoe backs, high arches and tight calf muscles.

Will a heel bump go away? The bone won't shrink, but symptoms often settle when friction and Achilles strain are reduced.

When should I see a specialist? If pain lasts despite sensible shoes and padding, if a toe has stiffened, or if you have diabetes and any skin breakdown.

Book a Foot and Ankle Assessment

Mr Pavel Akimau is a Consultant Trauma and Orthopaedic Surgeon (GMC 6100148) with a particular interest in minimally invasive foot and ankle surgery. Book through the contact page.