Claw Toe vs Hammertoe: How to Tell Them Apart

Reviewed by the FootWell editorial team · Edited by Mustafa Bilgic · Last updated 21 June 2026 · ~8 min read

The quickest way to tell them apart is to look at which joints bend. A hammertoe bends only at the middle joint, buckling the toe upward like an upside-down V. A claw toe bends at three joints at once — the base of the toe lifts up while the middle and end joints curl down, gripping like a claw. A mallet toe bends only at the very last joint, so just the tip droops. This guide compares all three lesser-toe deformities side by side so you can recognise yours and understand the treatment options.

Quick comparison table

The lesser toes (the four small toes) each have three joints: the metatarsophalangeal joint (MTP) where the toe meets the foot, the proximal interphalangeal joint (PIP) in the middle, and the distal interphalangeal joint (DIP) near the tip. Each deformity is defined by which of these joints is held in the wrong position. The American Academy of Orthopaedic Surgeons groups them together as related lesser-toe deformities that share many causes.

Which joints bend in each

The differences come down to anatomy, and a clear mental picture makes them easy to remember.

Hammertoe — the middle joint

In a hammertoe, the proximal interphalangeal (PIP) joint is bent downward while the base and tip stay relatively flat. The result is a toe that hunches upward at the knuckle, so the prominent middle joint rubs against the top of the shoe. It most often affects the second toe, especially when a bunion pushes the big toe across and crowds it. We cover this deformity in depth on our hammertoe guide; here the focus is how it differs from its neighbours.

Claw toe — three joints at once

Claw toe is the most dramatic of the three. The metatarsophalangeal (MTP) joint at the base hyperextends (lifts upward), while both the PIP and DIP joints flex downward. The toe ends up gripping toward the sole like a bird's claw. Because it usually involves a muscle imbalance affecting the whole forefoot, claw toe commonly appears in several small toes at once and is more strongly linked to nerve and neurological conditions.

Mallet toe — the end joint

A mallet toe bends only at the distal interphalangeal (DIP) joint, the one closest to the nail. The tip of the toe curls down and presses into the ground or the front of the shoe, so a painful corn often forms right at the tip or under the nail. The rest of the toe stays straight.

What causes them

All three deformities develop when the small muscles and tendons that move a toe fall out of balance, so the toe is pulled into a bent position over time. According to the Mayo Clinic, footwear that forces the toes into a bent or cramped position is a leading factor. The usual contributors are:

• Tight, narrow or pointed shoes that squeeze the toes and never let them straighten
• High heels, which jam the toes forward into the toe box and load the forefoot
• Muscle and tendon imbalance, where the tendon pulling the toe down overpowers the one straightening it
• Nerve damage from diabetes or other neuropathy — a common driver of claw toe in particular
• Rheumatoid arthritis and other inflammatory joint disease, which damage and deform the toe joints
• A bunion that pushes the big toe across and crowds the second toe into a bent shape
• High arches (pes cavus), which alter the pull of the toe tendons and frequently produce claw toes
• Previous trauma to the toe, such as a fracture or a stubbed toe that healed in a bent position

Symptoms to watch for

Beyond the visible bend, these deformities share a recognisable set of symptoms because they all create abnormal pressure points inside the shoe:

• Corns and calluses on the top of the bent joint (hammertoe and claw toe) or at the tip of the toe (mallet toe and claw toe). See corns and calluses for treatment.
• Pain in the ball of the foot as the deformity shifts pressure onto the metatarsal heads — a pattern that overlaps with metatarsalgia.
• Rubbing, redness or blisters where the prominent joint catches on the top of the shoe
• Stiffness in the toe and difficulty straightening it, which worsens as a flexible deformity becomes rigid
• An aching, cramped feeling in the forefoot after a day in closed shoes

Flexible vs rigid — the key treatment fork

Whichever deformity you have, the single most important question for treatment is whether it is flexible or rigid. A flexible deformity can still be straightened by gently pushing the toe by hand; the joint has not yet stiffened. A rigid deformity is fixed in position and will not budge. Most toes start flexible and gradually become rigid if the underlying cause is not addressed.

This matters because flexible deformities respond well to conservative, non-surgical care that can genuinely improve the position. Rigid deformities can still be made comfortable with padding and roomier shoes, but straightening the joint itself usually requires a surgical procedure. The earlier you act — while the toe is still flexible — the more you can do without surgery.

Treatment and prevention

Conservative care is the first line for every lesser-toe deformity, and it is often enough when the toe is still flexible. The NHS and most foot specialists recommend starting with the simplest measures:

• Roomy, low-heeled shoes with a deep, wide toe box so the toes are not forced to bend. A wide-fitting shoe often makes an immediate difference.
• Toe pads, splints and crest pads to cushion pressure points and gently hold a flexible toe straighter
• Stretches and toe exercises — picking up a towel or marbles with the toes and manually stretching the joint helps keep it mobile
• Orthotics to redistribute pressure away from the ball of the foot and correct contributing mechanics such as high arches; see orthotics explained
• Corn and callus care to relieve the painful skin lesions that form over the deformity

When surgery is considered

Surgery is considered when the toe has become rigid, the pain is constant, conservative care has failed after a fair trial, or a corn or ulcer keeps recurring over the deformity. Procedures range from releasing or lengthening a tight tendon (for a flexible toe) to removing a small piece of bone or fusing the joint to straighten a rigid one. The choice depends on the deformity, its flexibility and your overall foot health, which is why an assessment matters.

Prevention

You cannot always prevent these deformities — some people are simply prone to them — but you can lower the risk and slow progression. Choose shoes with about a thumb's width of room beyond the longest toe, avoid prolonged time in high heels and pointed shoes, manage any bunion or high-arch mechanics early, and address foot pain before it becomes a fixed problem. If a toe is starting to bend, a check-up is worthwhile while it is still flexible; our guide to seeing a podiatrist covers the warning signs.

Frequently asked questions

What is the main difference between a hammertoe and a claw toe?

A hammertoe bends only at the middle joint (PIP), so the toe buckles upward like an upside-down V. A claw toe bends at three joints at once: the joint at the base of the toe (MTP) pulls upward while the middle (PIP) and end (DIP) joints curl downward, giving a claw-like grip. Claw toe also tends to affect several small toes together, while a hammertoe often starts in one.

Can a flexible bent toe be straightened without surgery?

Often yes, while the deformity is still flexible — meaning you can still gently push the toe straight by hand. Roomy shoes, toe splints or pads, daily stretching and exercises, and orthotics can ease symptoms and slow progression. Once the toe becomes rigid and fixed, these measures only relieve pressure; straightening the joint then usually requires surgery.

What causes claw toe, hammertoe and mallet toe?

The most common cause is footwear that crowds the toes — tight, narrow or high-heeled shoes — combined with a muscle imbalance between the small muscles and tendons that move the toe. Other contributors include nerve damage from diabetes, rheumatoid arthritis, a bunion crowding the second toe, high arches, and previous trauma. Claw toe in particular is often linked to nerve conditions.

Sources & further reading

• Lesser-toe deformities (hammer, claw and mallet toe), American Academy of Orthopaedic Surgeons (AAOS)
• Hammertoe and mallet toe overview, Mayo Clinic
• Toe and forefoot problems and footwear advice, NHS
• Foot health information, American Podiatric Medical Association (APMA)