A hammer toe is also known as a claw toe deformity, and is caused by changes in strength of the small muscles in the foot, worsened by tight and high heeled shoes. The presence of a bunion may also contribute to the development of a hammer toe deformity. The non operative treatment is to wear a slightly wider and roomier shoe, and the use of soft pads to prevent rubbing on the top of the toe on the shoe. Surgery is often required to slightly shorten and straighten the toe by removing the prominent part of the knuckle of the toe.