Hammer Toe: Symptoms, Treatment and Footwear Choices

01Hammer toe

What a hammer toe is

MedlinePlus describes hammer toe as a deformity in which the toe moves into a claw-like position: the middle joint of the toe is bent and the end of the toe bends downward. It most often affects the second toe, although other toes can be involved. Mayo Clinic notes that hammer toe and the related mallet toe usually occur in the second, third or fourth toes.

The condition may be present at birth or develop over time. MedlinePlus adds that, rarely, all the toes are affected, which may be caused by a problem with the nerves or spinal cord and needs medical assessment.

02Related problems

Hammer, mallet and claw toes versus bunions

Several toe problems look similar but involve different joints. Mayo Clinic explains that a hammer toe bends at the middle joint, while a mallet toe bends at the joint nearest the toenail. MedlinePlus describes the hammer toe position as claw-like.

A bunion is different again: it is a bony bump at the joint at the base of the big toe. Hammer toes and bunions can occur in the same foot, especially when shoes crowd the toes, but they are separate conditions; our guide on bunions explains that problem.

03Flexible or fixed

Flexible and fixed changes

Early on, the toe can usually still be moved and straightened. MedlinePlus explains that over time it may no longer be possible to move the toe and it becomes painful, and Mayo Clinic notes that the tendons and joints may tighten so that the toe stays bent.

This difference matters for treatment. A flexible toe may respond to footwear changes, pads and gentle stretching. A fixed, rigid toe should not be forced straight with tape or devices; it needs assessment to decide which options are suitable. MedlinePlus notes that early treatment can often avoid the need for surgery.

04Causes

Possible causes and contributing footwear

MedlinePlus says the most common cause is wearing short, narrow shoes that are too tight, which force the toe into a bent position until its muscles and tendons tighten and shorten. Mayo Clinic lists:

• high-heeled shoes or shoes that are too tight in the toe area, which crowd the toes so they cannot lie flat
• a toe that has been stubbed, jammed or broken
• toe muscles that are out of balance, putting pressure on tendons and joints
• arthritis and diabetes, which increase the risk of foot problems, and possibly genes

Both sources note that women are more likely to develop hammer toes, which MedlinePlus links to ill-fitting shoes and high heels, and that children can develop them from wearing shoes they have outgrown. Mayo Clinic adds that the cause is often not known.

05Symptoms

Pain, rubbing and skin problems

Symptoms described by the two sources include:

• an unusual bend in one or more toes
• pain when wearing shoes or walking
• difficulty moving the affected toe, and stiffness
• swelling and changes in skin color
• corns on top of the bent toe, where it rubs against the shoe
• calluses on the sole of the foot, from extra pressure

Mayo Clinic explains that shoes rub against the raised part of the bent toe and that the bent position can increase pressure on the toe bones, causing painful corns and calluses.

06Warning signs

When diabetes, wounds or worsening symptoms need care

MedlinePlus advises contacting a health professional if you have a hammer toe and:

• develop thick blisters or corns on your toes
• develop sores over your toes that become red and swollen
• have redness that extends up your leg
• have pain that gets worse
• have difficulty walking or fitting comfortably into shoes

Mayo Clinic advises seeing a professional for lasting foot pain that affects your ability to walk. Because diabetes increases the risk of foot problems, people with diabetes or reduced feeling in their feet should not cut corns themselves or wait to have a sore checked.

07Assessment

Clinical assessment

MedlinePlus explains that a physical examination of the foot confirms a hammer toe; the professional may find reduced and painful movement of the toes. The examination also shows whether the toe is still flexible or has become fixed, where the skin is under pressure and how footwear fits.

Further tests are decided by the clinician according to the findings, for example if surgery is being considered or another condition is suspected. Before the appointment, it helps to note which shoes you can and cannot tolerate, where the toe rubs, any skin changes and how far you can walk comfortably.

08Treatment

Footwear, pads, exercise and surgery

MedlinePlus suggests these footwear changes to relieve symptoms and avoid making the toe worse:

• wearing the right size of shoe, or shoes with a wide toe box
• avoiding high heels as much as possible
• using shoes with soft insoles to relieve pressure
• protecting the raised joint with corn pads or felt pads

Mayo Clinic adds that shoe inserts and other devices may relieve pain and pressure, and recommends shoes with enough toe room, low heels and laces or straps, bought at the end of the day when feet are larger and fitted to the larger foot. MedlinePlus mentions toe straighteners, made by a podiatrist or bought in shops; store-bought devices do not suit every toe, and a rigid toe should not be squeezed into one.

Gentle stretching exercises may help if the toe is not already fixed; MedlinePlus gives picking up a towel with the toes as an example. For adults whose toe is still flexible, our physiotherapy practice in Bilbao can help with foot exercises and walking after an assessment; we do not provide podiatry or foot surgery (consultations are in Spanish).

For severe hammer toe, MedlinePlus explains that an operation may be needed to straighten the joint, usually by cutting or moving tendons and ligaments and sometimes by removing or fusing bone. People usually go home the same day, but the toe may remain stiff and shorter afterwards. Surgery is considered for pain and function, not as a cosmetic or automatic step.

09Sources

Where the sources differ

MedlinePlus states that the most common cause is tight, short, narrow shoes, while Mayo Clinic lists shoes alongside injury, muscle imbalance and diseases such as arthritis and diabetes, and notes that the cause is often unknown. Both agree that footwear is central to prevention and relief.

MedlinePlus describes the claw-like position of hammer toe and gives more detail on treatment and surgery, while Mayo Clinic separates hammer toe from mallet toe and gives practical advice on buying shoes. Neither gives a fixed time for improvement or a guarantee that devices will straighten a toe. The MedlinePlus page was reviewed in August 2024 and the Mayo Clinic page is dated May 2025.

10Summary

In summary

A hammer toe bends at its middle joint, most often in the second toe. Tight, short, narrow or high-heeled shoes are common contributors, along with injury, muscle imbalance, arthritis and diabetes. Early on the toe is flexible; later it may become fixed and painful, with corns and calluses.

Shoes with enough toe room and low heels, soft insoles, pads and gentle stretching help many people, especially when started early. Surgery is an option for severe cases. Get prompt care for red, swollen sores, redness spreading up the leg or worsening pain, particularly with diabetes. Recording which shoes you tolerate, where the toe rubs, skin changes and walking comfort helps review progress.