Claw Toe / Hammer Toe

If you have a claw toe or hammer toe, you may notice that one or more toe joints are stuck in a bent position and become rigid over time. Depending on the joint affected, the toe may curl downwards. The joint might become swollen and red with pain along the toe joints.

Table of Contents

What is a Claw Toe or Hammer Toe?

A claw toe or a hammer tow is a toe deformity which causes the toe to bend downwards in a claw-like shape. Along with hammer toes and bone spurs, claw toes are among the most common toe deformities. Most commonly, these affect the 2nd through 5th toes and often cause corns. In severe cases, redness, swelling, and open sores can develop over time due to the increased tension on the skin over the bent joint.

What Are The Causes of a Claw Toe or a Hammer Toe?

Claw toes and hammer toes are often caused by genetics. In many cases, people are born with a foot type that will predispose them to developing claw toes over time. People with flat feet, high-arched feet, or flexible feet are more prone to these problems. Claw Toes and Hammer Toes are sometimes caused or made worse by a bunion deformity involving the big toe. When the big toe starts to drift inward towards the other toes it may cause increased pressure on the second toe or displace it upwards.

Other causes include long toes, tendon imbalance, injury, rheumatoid arthritis, diabetes and neuromuscular disease. Over time, the mechanics of your foot can increase the deformities, as can certain kinds of footwear. Women are more frequently affected because of the use of tight stockings and shoe styles like high heels.

What Are The Signs And Symptoms of a Claw Toe or a Hammer Toe?

If you have a claw toe or a hammer toe, you may notice that one or more toe joints are stuck in a bent position and become rigid over time. Depending on the joint affected, the toe may curl downwards. The joint might become swollen and red with pain along the toe joints. Corns, calluses, blisters, and toe pain will often develop due to the friction of the toe rubbing in the shoe. This rubbing in the shoe may also cause the formation of a red, inflamed sac of tissue called bursitis.

What Are The Risk Factors?

Genetics and the natural shape of your foot are factors in the formation of claw toes and hammer toes. You are at a higher risk if you have high arches or a tendon imbalance within your foot. Shoes that are too narrow, ill-fitting, high heeled or have pointed toes can also increase your likelihood of developing toe deformities. These deformities can also be caused by injuries from medical conditions including rheumatoid arthritis, diabetes or neuromuscular disease.

How is a Claw Toe or a Hammer Toe Diagnosed?

A podiatrist can often diagnose these conditions with visual inspection and performing a physical and biomechanical exam. They will usually test for stiffness, reduced range of motion, or pain from specific motions of the joint. X-rays may also be used to make an accurate diagnosis.

What Are Possible Treatments?

When hammer toes and claw toes cause mild pain, the simplest solution is wearing wider, more accommodating shoes to decrease friction. Helpful changes to footwear may include smaller heels, softer material such as mesh and wider toe boxes. Cushions and various soft pads over the toes or insoles may provide relief from shoe pressure. You should avoid “medicated” corn pads over the toes, which contain a strong acid that can cause chemical burns or deep open sores that pose a high risk of infection.

Surgical options should be discussed with your podiatrist if the condition continues to be painful despite conservative therapy or if finding a pair of comfortable shoes becomes a challenge.

The longer surgery is delayed in a symptomatic foot, the greater the amount of deformity that may develop. Patients who have their symptomatic hammer toes and claw toes corrected earlier tend to have greater satisfaction and recovery after the procedure.

Surgery For Hammer Toe & Claw Toe
The goal of surgical correction is to restore normal alignment and function of the toe joint. Different procedures will be recommended depending on whether the toes are still flexible or if they have become rigid, or if a claw toe is present. Sometimes a small pin is placed inside the bones to hold the toe in a proper position while it heals. If a bone spur is the cause of the problem, this can be removed through a small incision often closed by one stitch.

Recovery from Hammer Toe & Claw Toe Surgery
Following surgery, the foot is bandaged and a post-operative shoe is worn for one week. Your podiatrist may recommend wearing athletic shoes after the first week. Weight bearing exercise and prolonged standing are restricted for the first 6-8 weeks. You may gradually resume activities and transition out of the surgical shoe once healing is complete.

Are There Preventative Steps or Measures To Avoid a Claw Toe or a Hammer Toe?

One of the easiest ways to prevent development of claw toes and hammer toes is to wear sensible footwear that doesn’t cause friction or strain to the toes. Avoiding high heeled shoes, flip flops and pointed toe shoes is recommended. There are daily exercises that you can do to help strengthen your muscles in case the deformity is caused by a muscle imbalance. Regularly taking care of corns and calluses using a pumice stone or other treatments can alleviate pain and discomfort.

What Are The Risks If Left Untreated?

Initially, toe deformities are flexible and can be treated with simple measures. However, if left untreated, they can become rigid or stiff to the point where they cannot be straightened easily, which causes increased pain. As time goes on, pain may develop deep in the toe joints and the ball of the foot, limiting walking, exercise or even just standing comfortably. Ignoring the early symptoms may cause the condition to worsen to the point that conservative treatments are ineffective and surgery is necessary.

Are There Other Related Conditions To a Claw Toe or a Hammer Toe?

Bone spurs are the other primary toe deformities which affect the lesser toes. Bunions may cause the big toe to bend inward, increasing the risk of these deformities.

Meet Weil Foot & Ankle Institute

Weil Foot & Ankle Institute was founded in 1965, by Dr. Lowell Weil Sr, who was inspired by a need to progress the Foot & Ankle Care category into the future through innovation. As one of the first Doctors of Podiatric Medicine (DPM), Dr. Weil…

By: Weil Foot & Ankle Institute, Published: May 23rd, 2022
Review By: Lowell Weil Jr., DPM – Jan 19th, 2023