Why do hammertoes get worse over time?

The word to look at in this question is "worse," and the sources that use it are specific about what comes with it.

Progressive, in the surgeons' own term

The American College of Foot and Ankle Surgeons describes hammertoes as progressive. It states that they do not go away by themselves and usually get worse over time. It adds that hammertoes usually start out as mild deformities and become progressively worse.

What "progressive" commits you to

Two parts of that wording matter. The first is "do not go away by themselves," which rules out waiting as a plan that clears the toe. The second is "usually," which describes a typical course and does not promise that every toe follows it. Neither sentence gives a timetable, so be skeptical of anyone who quotes you a speed.

The lesser toes get their own section in a Royal National Orthopaedic Hospital patient guide on bunions and lesser toe deformities, which is the wider read. The AAOS OrthoInfo page on tight shoes and foot problems is a separate page on footwear, and it is worth reading beside the toe guide.

What to confirm, and with whom

Ask your podiatrist how mild or advanced your toe is today, and what they would compare against at a later visit. A written baseline gives any later visit something to be measured against. If you live around Itasca, any foot and ankle office nearby can record that baseline.

When the toe rubs, the APMA page on corns and calluses covers the skin that forms on top of it.

The clause readers tend to skip

"Usually start out as mild" is easy to read as reassurance. Read it next to "get worse over time" and it describes a starting point, not a stopping point.