# Claw toe > Claw toe is a curling of the smaller toes, where the toe bends up at its base and down further along. Wider, deeper shoes with a soft upper, plus pads, are the usual first steps. Surgery is kept for toes that don't improve. Guide in [Toes and forefoot](https://footanklelowerlimb.com.au/learn/topics/toes-and-forefoot), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/claw-toe Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's a curled smaller toe:** the toe bends up at its base and down further along, like a claw. - **Shoes come first:** wider, deeper shoes with a soft upper, plus pads, are the usual first steps. - **It can stiffen over time,** so it's worth having a curling toe checked. - **Surgery is for toes that don't improve** with other care. - **Diabetes needs extra care,** because foot sores can go unnoticed. ## What is claw toe, and how common is it? Claw toe is a curling of the smaller toes. The joint at the base of the toe (the metatarsophalangeal or MTP joint) bends upward, and the joints further along bend down, so the toe curls like a claw [1]. It's one of the lesser toe deformities (shape changes in the smaller toes). Early on, the toe is usually flexible. Over time it can become fixed in position, and it can get worse if it's left alone [2]. It affects women more often than men, and it's one of the most common foot problems in older people [1]. Claw, hammer and mallet toe are described differently from one source to the next [3], so it helps to tell your podiatrist which joints bend and in which direction. ## What causes claw toe, and who gets it? Often there's more than one cause. Neurological conditions (affecting the nerves) are the most common. Others include inflammatory arthritis, bunions, a high-arched foot, unusually long metatarsals (the long bones behind the toes), and high-heeled or ill-fitting shoes [1]. Nerve damage in the feet (for example from diabetes) and injury can also change toe shape [2]. The usual explanation is an imbalance between the small muscles inside the foot and the larger muscles outside it. The exact mechanism isn't clear, and in people with diabetes it's likely more complicated than that [4]. Shoes that don't fit the width or length of the foot are linked with lesser toe deformity in older people [5]. That's an association, not proof that shoes cause it. ## What does claw toe feel like, and how is it diagnosed? Claw toe is often painful, and the second toe is the one most often affected [1]. The pain usually comes from the bent joints rubbing on the inside of the shoe, which can lead to corns, calluses or sores on the top or tip of the toe [1][2]. You may also notice blisters, hard skin, nail changes or pain under the ball of the foot, and one or several toes can be affected [6]. Diagnosis is mostly by looking and asking. A podiatrist or GP will check the toe and the skin around it for corns, calluses, sores and nail changes [7]. They may ask about numbness, tingling, burning or weakness, which can point to a nerve cause [8]. A wound that won't heal can point to a circulation or nerve problem [7]. ## What helps first? Non-surgical care comes first, and it's preferred over surgery [1]. Many people respond to it [9]. - **Shoes:** choose shoes that are wider and deeper at the toes, with a soft upper that moulds around them [2][9]. Avoid shoes that squeeze the toes. - **Pads and sleeves:** pads or toe sleeves can take pressure off sore spots [9]. Silicone gel pads and taping are other options a podiatrist can show you [1]. - **Pain relief:** a pharmacist can advise on painkillers [10]. It isn't clear yet which option works best, because few trials exist [1][9]. If you have diabetes, circulation problems or reduced feeling in your feet, have a podiatrist check your foot before using pads, tape or splints, because skin damage can go unnoticed. If nothing has noticeably changed after six to twelve weeks, see your GP or podiatrist. ## What helps if that isn't enough? Surgery is the main next step. It's kept for toes that don't improve with non-surgical care [11]. Your GP or podiatrist can talk to you about referral to an orthopaedic foot and ankle service. Surgery aims for a well-aligned toe, but it often costs some grip or leaves the toe stiff [9]. After surgery on severely deformed, stiff toes, about 5–10 in 100 toes are a little numb or sensitive. Rarely, the blood supply to a toe is so badly affected that it dies or has to be amputated [11]. People with diabetes, circulation problems or nerve damage need particular care and advice before surgery. Before agreeing, talk through these risks and your own situation. ## What's the outlook, and can I stop it coming back? Claw toe often starts as a curl you notice only when walking. Over time it can become permanent [9]. Lesser toe deformities also raise the risk of falls in older people [1]. How long recovery takes after surgery, and how often the toe curls again, isn't clear yet. Ask your surgical team for realistic information, and don't assume the correction is permanent. To keep pressure off your toes, it can help to avoid long periods of walking or standing, high heels, tight pointed shoes, flip-flops, backless slippers and walking barefoot on hard surfaces [2]. It isn't clear yet whether this stops claw toe coming back. Have the toe reviewed if it becomes stiffer or more painful, or starts to rub or break the skin, and report any return of symptoms promptly. ## When to see a podiatrist See a podiatrist or your GP if a toe is curling, painful or rubbing in your shoes, because it can get worse over time [2]. Podiatry review is also advised for toe pain that persists, pain under the ball of the foot despite self-care, or a deformity that's getting worse and affecting daily activities [7]. See your GP soon for tingling or numbness in your feet, burning or weakness in a limb, night sweats, fever or weight loss [6][8], or swollen, tender glands in the groin [6]. These need urgent medical assessment: your GP or a podiatrist the same day, a Medicare Urgent Care Clinic, or the emergency department: - a cut or blister that hasn't started to heal after a few days, or a callus with dried blood inside it [12]; - red, warm or painful skin, or a black, smelly infection (possible gangrene) [12]; - severe pain in the foot or ankle, a foot that has changed shape, or being unable to walk more than 2 or 3 steps [6]; - after toe surgery, any sign of infection or a wound problem: contact your surgical team, your GP or a podiatrist the same day. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. > [!see] If you have diabetes > Claw toes are linked with a higher risk of foot ulcers and amputation in people with diabetes [4]. Have a thorough foot exam at least once a year, including a check of the feeling and pulses in your feet. Have one at every health care visit if your foot has changed shape, you've lost feeling, or you've had an ulcer or amputation [12]. A red, hot or swollen foot needs urgent medical assessment, and it's worth raising any foot problem with your GP [6]. ## Common questions ### What is the difference between claw toe, hammer toe and mallet toe? They're all lesser toe deformities, where a smaller toe bends out of its normal shape. In claw toe, the base joint bends up and the middle and end joints bend down. The names are used inconsistently, so a podiatrist can tell you which one you have by looking at which joints bend. ### Can claw toes be straightened without surgery? Non-surgical care mainly aims to ease pressure and pain, and many people find it helps. Wider shoes may also help stop the toe getting worse. Whether it straightens the toe isn't clear yet. A podiatrist can talk through what to expect for your own toes. ### Can claw toe cause pain under the ball of the foot? Yes, it can. The bent joint at the base of the toe is believed to raise pressure under the ball of the foot, which may lead to pain there (metatarsalgia). Tell your podiatrist or GP where it hurts and whether certain shoes make it worse, so they can check the skin and look at ways to take pressure off. ## Further reading - [Claw toe on Clindice](https://clindice.com/claw-toe) - [Hammer toe: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001235.htm), MedlinePlus - [Claw Toes: Causes, Stages, Treatment & Prevention](https://my.clevelandclinic.org/health/diseases/16875-claw-toes), Cleveland Clinic - [Lesser toe deformities - NHS Lanarkshire](https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/lesser-toe-deformities/), NHS - [Claw Toe - OrthoInfo - American Academy of Orthopaedic Surgeons](https://www.orthoinfo.org/diseases--conditions/claw-toe/), OrthoInfo (American Academy of Orthopaedic Surgeons) - [Pain in your toe or the ball of your foot - lesser toe deformities - Bradford District Care NHS Foundation Trust](https://www.bdct.nhs.uk/pain-in-your-toe-or-the-ball-of-your-foot-lesser-toe-deformities/), NHS ## Sources 1. A systematic review of the claw toe deformity: What is known and what is needed apart from surgical procedures · Mayagoitia-Vázquez JJ, López-López D, Miguel-Andrés I et al. · International Wound Journal · 2024. https://doi.org/10.1111/iwj.70073 2. Pain in your toe or the ball of your foot - lesser toe deformities · Bradford District Care NHS Foundation Trust · 2025. https://www.bdct.nhs.uk/pain-in-your-toe-or-the-ball-of-your-foot-lesser-toe-deformities/ 3. Defining and Evaluating Claw Toe and Hammertoe Deformity: A Scoping Review and Questionnaire Study · Mens MA, Stufkens SAS, Busch-Westbroek T et al. · Journal of the American Podiatric Medical Association · 2025. https://doi.org/10.7547/23-224 4. Associations Between Diabetic Foot Deformity and the Intrinsic Foot Muscles: A Systematic Review · Hanna T, Latey P, Ekanayake K et al. · Journal of Foot and Ankle Research · 2025. https://doi.org/10.1002/jfa2.70068 5. Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature · Buldt AK, Menz HB · Journal of Foot and Ankle Research · 2018. https://doi.org/10.1186/s13047-018-0284-z 6. Lesser Toe deformities - Problems with the small toes · NHS. https://www.esht.nhs.uk/wp-content/uploads/2020/07/0834.pdf 7. East Sussex MSK Community Partnership · NHS. https://eastsussexmsk.nhs.uk/wp-content/uploads/2025/10/Foot-Ankle-Triage-Guidance-2025.pdf 8. Foot and ankle history and clinical examination: A guide to everyday practice · Alazzawi S, Sukeik M, King D et al. · World Journal of Orthopedics · 2017. https://doi.org/10.5312/wjo.v8.i1.21 9. The pathology and management of lesser toe deformities · Malhotra K, Davda K, Singh D · EFORT Open Reviews · 2016. https://doi.org/10.1302/2058-5241.1.160017 10. Claw, Hammer and Mallet Toe Deformities · NHS. https://www.nnuh.nhs.uk/publication/download/lesser-toe-deformities-v6/ 11. Lesser toe deformities · NHS. https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/TraumaandOrthopaedics/5422-2-Lesser-Toe-Deformities.pdf 12. Diabetes & Foot Problems · National Institute of Diabetes and Digestive and Kidney Diseases · 2026. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.