Understanding the Differences Between Hammer Toe & Claw Toe

Hammer toe and claw toe are both conditions that cause an unnatural bend of the toes. These conditions affect the movement of the toes and can cause deformities of the foot. While both conditions are similar, hammer toe causes the toes to bend in a downward direction at the middle toe joint causing difficulty to flex the foot or move the toes. Claw toe gets its name from the toes resembling a claw-like look in which the toes bend upwards from the joint at the base of your toe and then bend downwards from the middle joint. 

Let’s take a look at both of these conditions to better understand the signs and treatment options:

Similarities of hammer toe and claw toe

Hammer and claw toe can both cause intense pain and calluses or corns may develop from the constant rubbing of the misshapen toes against footwear. In more severe cases, these conditions can also cause difficulties with walking and maintaining balance. 

Factors that can cause either of these conditions include:

• Long term usage of shoes that do not fit properly, or shoes that have little arch support
• Long term usage of shoes with a high heel
• Trauma or injury to the toes
• Foot or ankle injury
• Muscle imbalance
• Existing metabolic condition such as arthritis
• Nerve damage to the foot due to conditions such as diabetes and stroke

Frequently, hammer toe and claw toe are seen in patients who wear footwear that is too tight over a prolonged period, which causes the toes to stay in an unnatural bent position, tightening the muscles and shortening the tendons. This increases the difficulty to straighten the affected toes and they may remain curled even when footwear is removed. Women who wear high heels are also at higher risk to develop these conditions due to the angle of the heels pushing the foot further into an unnatural, tightened position over long periods of time.

Differences of hammer toe and claw toe

Those with hammer toe often have a longer second toe, while those with claw toes often have a higher foot arch or muscle imbalance.

The location of the affected toe joints differs for hammer and claw toe. Hammer toe affects the second or middle joint in the toe, which causes it to bend downwards. It usually only affects a single toe. Claw toe can affect one or multiple of the smaller toes and can even occur to all of the four smaller toes. It affects the middle and end toe joints which causes the toes to bend and curl under. 

Symptoms

Hammer toe and claw toe have symptoms such as:

• Pain in the affected toe / toes
• Toe / toes look bent
• Loss of toe flexibility
• Swelling and/or redness of the toes
• Presence of corns and calluses
• Difficulties walking or maintaining balance

Diagnosis

Before diagnosing your condition, you may be asked some questions by your doctor about your symptoms and existing health conditions. Your doctor will also examine your foot to check if the toe joint is flexible or rigid. Flexibility of your toes means that your condition is still in the early stage, while rigidity in your toes means a later stage of the condition where your toes are stuck and unable to move. You may also be recommended for further tests like X-rays, blood flow testing and nerve testing. You may then be diagnosed with hammer toe or claw toe.

Treatment

Treatment options for both conditions are similar and can include pain medication, orthotics or inserts to relieve pressure or pain and reposition the toes, comfortable shoes with extra room in the toes, surgery and exercise to stretch and strengthen toe and foot muscles. 

If you’re experiencing severe pain in your toes or feet, unable to walk properly without assistance or any of the symptoms above, it is best to set up an evaluation with a foot and ankle specialist like OrthofootMD as soon as possible.

Dr Gowreeson Thevendran is an orthopaedic surgeon with extensive expertise in lower limb orthopaedic conditions and specialises in minimally invasive surgical techniques in the treatment of foot and ankle, knee and hip/thigh conditions. Prior to establishing his private orthopaedic clinic in Singapore, Dr Gowreeson was Chief of Foot and Ankle Surgery at the Department of Orthopaedics in Tan Tock Seng Hospital. 

You can be sure you’re in good and caring hands for your hammer toe and claw toe conditions and you’ll be back on your feet in no time! Book an appointment with us today!