# Hammertoe > A hammertoe is a smaller toe that bends down at its middle joint, leaving it curled like a hammer. Roomy, soft shoes and simple padding or taping are the usual first steps, and early on the toe is usually flexible. 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/hammertoe Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **A hammertoe is a smaller toe bent down at its middle joint,** leaving it curled like a hammer. - **It's usually flexible at first,** so early changes are worth acting on. - **Roomy, soft shoes come first,** with padding or taping if a podiatrist suggests it. - **Surgery is kept for toes that don't improve** with simple care. - **If you have diabetes,** see your GP or a podiatrist the same day for any sore, blister or colour change on your foot. ## What is a hammertoe? A hammertoe is a change in the shape of one of your four smaller toes. The middle joint (the proximal interphalangeal, or PIP, joint) bends down, leaving the toe curled like a hammer [1]. Experts don't fully agree on exact definitions, so related changes such as mallet toe and claw toe can be named differently from one source to the next [2]. At first the toe is usually flexible, but it can become fixed in its new position over time if it isn't treated [3]. To check, gently try to straighten the toe with your hand and notice whether it moves. ## What causes a hammertoe, and who gets it? A hammertoe develops when the muscles and tendons that hold the toe straight and those that bend it fall out of balance [3]. Things that can contribute include a bunion (hallux valgus), rheumatoid arthritis, a past toe injury, and conditions affecting the nerves, brain or spinal cord, including nerve damage from diabetes [3]. Tight or cramping shoes are often blamed. Incorrectly fitted shoes are linked with toe deformities in older people [4], but that is a link, not proof that shoes cause a hammertoe. Checking that your shoes have room for your toes in both width and length is a sensible step either way. ## What does it feel like, and how is it diagnosed? You may notice the toe looks different, with pain or irritation in shoes, redness, swelling, and corns or calluses (patches of hardened skin) over the top joints or the tip of the toe [1][3]. The joints can be stiff, and because your smaller toes help with walking and balance, you may walk differently [5]. Some people have a changed toe shape and no problems at all [5]. A podiatrist can usually assess a hammertoe by looking at it and checking whether it still straightens. Bring the shoes you wear most. An X-ray is used if surgery is being considered [6]. Some other problems can feel similar. Burning or shooting pain between the toes that eases when you rest or take your shoe off may be a nerve problem (Morton's neuroma) [6]. If inflammatory arthritis is possible, it needs to be ruled out [6]. ## What helps first? Simple care comes first, and surgery is kept for people who don't improve [7]. The most consistent advice is roomier shoes. Choose shoes with a soft upper, a wide and deep toe box, no seams over the sore spot, and laces or adjustable straps [8][5]. Avoid narrow shoes, and have your feet measured so you know your size and width [4]. A podiatrist can add footwear advice and orthotics (shoe inserts) [6]. For claw toe, a related change, silicone gel pads and taping or strapping the toe should be tried before surgery [9]; ask a podiatrist whether they suit your toe. Most of this advice comes from health-service guidance rather than trials in hammertoe, so how well each step works isn't clear yet. If you have diabetes at moderate-to-high risk of foot ulcers, or you've had one, your foot-care team can arrange properly fitting therapeutic footwear [10]. ## What helps if that isn't enough? If simple care hasn't relieved your symptoms, a podiatrist or GP can refer you on to discuss surgery [6][7]. If you're considering it, ask which procedure is planned, how long recovery takes and what the risks are. Smoking and diabetes raise the risk of infection after toe surgery, so raise either one beforehand [11]. For adults with diabetes who have a flexible hammertoe with skin damage that could turn into a sore, a procedure to release a tendon may be considered [10]. ## How long does it take, and can it come back? A flexible hammertoe can become fixed over time if left untreated, so it's worth acting on early changes [3]. Wear shoes with room for your toes, and replace shoes that are narrow or rub [8]. Knowing your foot size and width helps you choose well [4]. Roomy shoes can ease pressure and friction, but it isn't clear yet whether they stop a hammertoe coming back. If you have diabetes, keep up regular foot checks: yearly if your risk of foot ulcers is very low, and more often if it's higher [10]. Foot self-care, suitable protection on your feet and treating any corn or callus early are recommended to prevent ulcers [10]. ## When to see a podiatrist See your GP or a podiatrist the same day if: - you have diabetes and notice a wound, sore, blister or colour change on a foot; - you have an open wound or sore on a toe or foot, or a change in circulation [12]; - redness, heat, swelling or pus is spreading in your foot. Take weight off the foot until you're seen [12]. 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 a podiatrist or your GP if: - your toe is changing or getting worse, because it can become fixed [3]; - pain increases markedly after exercises, or nothing has changed after six to twelve weeks of self-care [3][12]; - you have corns or calluses over a bent toe, since they can progress to ulcers [9]. See your GP if the toe changed shape after an injury, or you have symptoms elsewhere in your body, as it may be something other than a hammertoe [13]. Mention other swollen joints too, as these can point to another condition [6]. > [!see] If you have diabetes > Reduced feeling in your feet can hide damage, and narrow shoes can injure your skin [12]. Look at your feet regularly for cuts, blisters, sores or colour changes, and keep up your regular foot checks. ## Common questions ### What is the difference between hammertoe, mallet toe and claw toe? They're named for which joints are bent. In a hammertoe, the middle joint of the toe bends down. In a mallet toe, it's the joint nearest the tip. In a claw toe, the joint at the base of the toe bends up while the other two joints bend down. Definitions vary, so the names are sometimes used differently. ### Why does my second toe curl with a bunion? A hammer second toe is often seen alongside a bunion. The shape or position of the big toe can change how much space the smaller toes have, which may push them to change shape or position. If you have a bunion and a curling toe, a podiatrist can look at both together. ### Can a hammertoe be straightened without surgery? Simple steps such as roomy shoes, padding or taping are tried before surgery, mainly to relieve pressure and rubbing. Early on, the toe is usually flexible, which is why acting on changes sooner is worthwhile. A podiatrist can talk through which options suit your toe and how long to try them. ## Further reading - [Hammertoe on Clindice](https://clindice.com/hammertoe) - [Hammer toe: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001235.htm), MedlinePlus - [Hammer Toe Surgery (Arthroplasty/Arthrodesis) - North Tees and Hartlepool NHS Foundation Trust](https://www.nth.nhs.uk/resources/hammer-toe-surgery-arthroplasty-arthrodesis/), NHS - [Hammer toes](https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/hammer-toes/), Arthritis UK - [Digital Deformities](https://msk-bexley.nhs.uk/conditions/foot-and-ankle-pain/digital-deformities), NHS - [Claw, Hammer and Mallet Toe Deformities](https://www.nnuh.nhs.uk/publication/download/lesser-toe-deformities-v6/), NHS ## Sources 1. Lesser toe deformities · NHS Lanarkshire. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/lesser-toe-deformities/ 2. 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 3. 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/ 4. 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 5. Lesser toe deformities · Norfolk & Waveney Community Musculoskeletal Services (NoW MSK). https://www.norfolkandwaveneycommunityhealth.nhs.uk/msk/self-help/foot-and-ankle/lesser-toe-deformities/ 6. Foot & Ankle · NHS. https://nhsdorset.nhs.uk/Downloads/aboutus/finance/04_MSKT_0007%20MSK%20Interface%20Service/04_MSKT_0007%20Foot%20+%20Ankle%20Treatment%20Guidance.pdf 7. Lesser toe deformities · Shirzad K, Kiesau CD, DeOrio JK et al. · The Journal of the American Academy of Orthopaedic Surgeons · 2011. https://doi.org/10.5435/00124635-201108000-00006 8. Digital Deformities · NHS. https://msk-bexley.nhs.uk/conditions/foot-and-ankle-pain/digital-deformities 9. 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 10. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update) · Bus SA, Sacco ICN, Monteiro-Soares M et al. · Diabetes/metabolism Research and Reviews · 2024. https://doi.org/10.1002/dmrr.3651 11. Claw, Hammer and Mallet Toe Deformities · NHS. https://www.nnuh.nhs.uk/publication/download/lesser-toe-deformities-v6/ 12. Diabetes and what it means to your feet · NHS Lanarkshire · 2022. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/diabetes/ 13. G-care: The primary care clinical information system · NHS. https://g-care.glos.nhs.uk/clinical-topic/hallux-valgus-bunion --- 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.