Claw toes is named for its similarity to the claw of an animal. The toe is bent upward at the joint at the ball of the foot, and then downward at the middle joint and joint at tip of the toe. It typically occurs in the lesser toes.
The deformity is caused when an imbalance occurs between the two sets of muscles that cause the toe to flex or extend. When one set over powers the other the deformity occurs. The deformity is flexible initially and over time becomes rigid or non-reducible.
- Hereditary – you inherited a tendency to develop a hammertoe because your foot is not stable. Common with people with flat feet but can occur in individuals with a high arched foot.
- Injury to the toe can also cause mallet toes. Repetitive injury due to poor fitting shoes or fracture of the toe can lead to the deformity.
- Diseases of the joints can result in the deformity such as osteoarthritis or rheumatoid arthritis.
- Diseases that affect the nerves and muscles such as diabetes, multiple sclerosis, cerebral palsy, and stroke can result in the deformity.
Claw toes can present with variety of symptoms due to the position of the toe. Pain can be at the tip of the toe due to pressure and can affect the nail. Pain due to shoe pressure can also occur on the top of the toe. Because the toe is extended on the joint at the level of the ball of the foot, increased pressure can occur in the joint or on the bottom of the foot.
- Proper shoe gear.
- Adequate arch support.
- Deep and wide toe box.
- Avoid pointed toes.
- Length of the shoe should be 3/8” to 1/2 “ from the LONGEST toe. Avoid high heels for any extended periods of time.
- For deformities that are still flexible or reducible stretching exercises may help. Gently pull the toe to stretch the bent toe in the opposite direction.
Treatment is designed to limit irritation of the toe. This can be achieved by conservative and surgical options.
Conservative treatment options include:
- Changes in shoe gear
- Over the counter inner soles or orthotics with metatarsal pad
- Topical pads made of foam, felt or silicone. I like the silicone toe caps.
- Buttress pads work well in preventing the tip of the toe to hit the shoe.
- If the deformity is still flexible you can tape the toe.
- Lubrication of the friction points can help slow down the development of thickened skin.
- Padded socks can also decrease pressure.
If the toe is already inflamed warm soaks followed by ice works well. OTC NSAIDS like ibuprofen and naproxen.
Avoid use of chemical corn removers or the cutting of corns especially if you are diabetic, have circulation or immunity problems.
Surgical treatment designed to straighten the toe:
Should conservative options fail to alleviate the condition there are surgical options available. If the deformity is still flexible tendon work alone may be an option. Once the deformity is rigid, tendon and bone work would be required at each level of the deformity. The toe may be fused to prevent reoccurrence especially if the deformity was due to a neuromuscular disease. A pin would be used to maintain the position.
*For products related to the conservative care of hammertoe deformities we recommend footsupplystore.com
*To make an appointment with one of our physicians to evaluate your claw toe deformity please call our office (numbers below) or fill out the contact form and we will contact you.