Claw Toe

Structural and Postural Conditions· Also known as: claw toes, clawed toesUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

Claw toe is a curling of the smaller toes, most often the second toe. The joint at the base of the toe bends up and the two joints beyond it bend down. It is one of the most common foot problems in older people and affects women more often than men. The main signs are a curled toe, and pain or hard skin where it rubs on your shoes. The toe is usually flexible at first but can become fixed over time. Many people do well with non-surgical care such as roomier shoes, pads and podiatry care. Surgery is kept for people who don't improve.

What is it?

Claw toe is a change in the shape of one or more of your smaller toes. The joint at the base of the toe (where it meets the foot) bends upwards. The two joints further along the toe bend downwards, so the toe curls like a claw. It is seen most often in the second toe.

At first the toe is usually flexible. Over time it can become fixed in its bent position. Health professionals may also call it a lesser toe deformity (a change in the shape of one of the smaller toes).

Who does it affect?

Claw toe is one of the most common foot problems in older people. It affects women more often than men.

Several things can make it more likely: conditions that affect the nerves and muscles, inflammatory arthritis such as rheumatoid arthritis, nerve damage in the feet (for example from diabetes), an injury to the toe, bunions, high-arched feet, and unusually long bones in the front of the foot. Your genes may play a part too. Tight shoes and high heels are also linked with it.

If you have diabetes, claw toes matter a little more. They are linked with a higher chance of foot sores (ulcers) and, in some cases, amputation. Diabetes can also damage the nerves in your feet, which affects up to 50 per cent of adults with diabetes. You might not feel a blister or a pebble in your sock, so regular foot checks are important.

Signs and symptoms

The most obvious sign is a toe that curls down, with the middle and end joints bent. It can get worse over time if it isn't treated.

Most of the discomfort comes from the bent joints rubbing on the inside of your shoe. You may get:

pain in the toe
corns or hard skin (calluses) on top of the toe joints or at the tip of the toe
redness, swelling or stiffness around the joints
shoes that feel uncomfortable over the toes
toes that rub together and cause blisters, hard skin or open sores
changes in the look of the toenails

Over time, the rubbing can lead to sores. That is one reason it is worth getting a curling toe looked at early.

What causes it?

The exact cause isn't fully understood. It is mainly linked to an imbalance between the small muscles inside the foot and the larger muscles outside it, or to weakness in the tissues that hold the joint steady (the joint capsule and ligaments). In people with diabetes, this muscle-imbalance idea is thought to be too simple. Several things are likely to be involved, including wasting of the small muscles in the foot.

The causes and risk factors listed above all play a part in different people. Diseases of the nerves and muscles are the most common cause. Badly fitting or high-heeled shoes are linked with toe changes like this, but that doesn't prove the shoes caused them.

How is it diagnosed?

Claw toe is mainly diagnosed by looking at your toes and asking about them. Your podiatrist will look at the shape of the toe and the skin around it. They will check for corns, calluses, blisters, sores, nail changes and signs of infection.

They will ask how many toes are affected, where the rubbing happens, and whether your shoes cause or worsen the symptoms. They may measure the angle of the joint at the base of the toe.

They will also ask about numbness, weakness, burning, and any sores that won't heal, and may check the pulses in your feet. This helps rule out other causes, such as an injury, a nerve problem, poor blood flow or arthritis.

Treatment

Care starts without surgery. Many people respond to non-surgical treatment. There is no agreed best treatment, and it isn't yet known which of the options works best.

Looking after it at home

Choose shoes that are wider and deeper at the toes, with a soft upper. Soft materials mould around the toes more easily than hard leather. Avoid shoes that squeeze your toes. Wider shoes may ease symptoms and help stop the toe getting worse.

Pads or toe sleeves over the top of the toe joint, and under the ball of your foot, can take pressure off sore spots. Painkillers may help with pain.

If you have diabetes, poor circulation or reduced feeling in your feet, have your foot checked by a professional before you use pads, tape or splints. Skin damage can go unnoticed.

Treatment from your podiatrist

Your podiatrist can advise on pads and other appliances, and look after corns, calluses and the skin of your toes. Taping or strapping the toe may suit some people. Physiotherapy and podiatry measures are also used, and the treatment takes account of what is causing the toe to curl.

If you have diabetes and a toe or foot deformity, exercises that strengthen the small muscles in your foot are suggested. See your GP or podiatrist if your pain increases markedly after the exercises, or if nothing has changed after six to twelve weeks.

If you have diabetes and are at low to moderate risk of foot sores, it can help to do a foot and ankle exercise programme, ideally supervised. This is aimed at lowering your chance of sores rather than straightening the toe. If you have had a sore under your foot before, special footwear that relieves pressure under the foot can help stop it coming back.

Other options

Injections of botulinum toxin (a medicine that relaxes muscles) are listed as a non-surgical option. How well it works for claw toe isn't yet clear.

Surgery

Surgery is kept for people who don't improve with non-surgical care. If your symptoms continue despite shoe changes, padding and podiatry care, ask your GP or podiatrist about referral to an orthopaedic foot and ankle service (surgeons who treat foot and ankle problems).

The aim is a well-aligned toe that works well. Surgery often costs some of the toe's ability to grip, or leaves it stiff. In severely deformed and stiff toes, about 5 to 10 in 100 toes are a bit numb or sensitive afterwards. Rarely, the blood supply to a toe is so badly affected that the toe dies or has to be amputated.

If you have diabetes, circulation problems or nerve damage, you need particular care and specialist advice before surgery. Before you agree to it, talk through the chance of stiffness, loss of grip and numbness, and your own risk factors.

Recovery

Without treatment, a flexible toe can become fixed over time. The tissue under the joint at the base of the toe (the plantar plate) can tear, and the toe then stays bent. The deformity can get worse, so have the toe looked at again if it becomes stiffer, more painful, or starts to rub or break the skin.

It isn't clear yet how long recovery takes or how often claw toe comes back, including after surgery. If you are having surgery, ask your surgical team what recovery is likely to involve for you. Don't assume the toe is permanently corrected afterwards. Tell your team promptly if your symptoms return, or if you have a wound problem or signs of infection.

Preventing it

It isn't yet clear whether footwear or foot care stops claw toe coming back. Still, these steps are sensible, especially if you already have toe changes.

Wear shoes that fit both the width and length of your feet, with room for your toes. Deep shoes with a soft upper suit best.
Avoid high heels and tight, pointed shoes.
Avoid thongs and backless slippers.
Avoid walking barefoot on hard surfaces.
Avoid standing or walking for long periods.

If you have diabetes, get a thorough foot check at least once a year. It should include a check of the feeling and pulses in your feet. You should also have one at every health visit if your foot shape has changed, you have lost feeling, you have poor blood flow to your feet, or you have had a foot sore or amputation before. Learn how to look after your feet, avoid walking without suitable foot protection, and get any sore or pre-sore spot on your foot treated.

When to see a podiatrist

When to book

Book an appointment with your podiatrist if a toe is curling, painful or rubbing in your shoes, if the toe or the pain is lasting or getting worse, or if you have toe sores along with a circulation, nerve or autoimmune condition. See your podiatrist or GP soon if a cut, blister or bruise on your foot hasn't started to heal after a few days. See your GP soon if you have tingling, numbness, weakness or burning in your feet or legs, night sweats, fever or weight loss, or swollen, tender glands in your groin. If you have diabetes, see your GP about any foot problem.

When to get help sooner

Call your local emergency number if you have a foot wound or infection and you also feel very unwell, with confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine, as this could be sepsis. The following need urgent medical assessment: see your GP today, or go to an urgent care clinic or the nearest emergency department. They are a callus with dried blood inside it (this is often the first sign of a wound under the callus), skin on your foot that becomes red, warm or painful (a sign of possible infection), a black, smelly infection, a red, hot or swollen foot if you have diabetes, severe pain in your ankle or foot, pain that stops your normal activities, a foot, ankle or leg that has changed shape, being unable to walk more than 2 or 3 steps, or any sudden change in your foot that you can't explain.

Frequently asked questions

What is the difference between claw toe, hammer toe and mallet toe?

They are similar changes in toe shape, and even professionals use the names in different ways. Measuring the angle of the joint at the base of the toe can't tell claw toe from hammer toe. When you talk to a podiatrist or GP, it helps to describe which joints of your toe bend and in which direction.

Can claw toe cause pain under the ball of my foot?

It can. When the joint at the base of the toe bends upwards, it is believed to increase the pressure under the ball of your foot. That can cause pain there. Pads or toe sleeves placed under the ball of your foot can ease those pressure points.

Does claw toe raise the chance of falls?

Changes in the shape of the smaller toes, including claw toe, are a risk factor for falls in older people. Your podiatrist can look at your toes and the shoes you wear as part of your care.