Hammer toe is one of the most common toe deformities, occurring primarily in women. The problem most often affects the second and third toes. The joints of the toe become misaligned: the base of the toe moves upward, while the middle joint bends downward. The condition often occurs in conjunction with deformities of the big toe (such as bunions), as the altered foot structure causes the other toes to shift, become distorted, or overlap. Hammer toe is not only an aesthetic problem, but can also cause pain, difficulty wearing shoes, and walking problems. In some cases, the condition can be treated with conservative methods rather than surgery, but in advanced cases, surgery is often the only permanent solution.