What Is Claw Toe?
Claw toe is a common foot deformity in which your toes bend into a claw-like position, digging down into the soles of your shoes and creating painful calluses on the top or tips of the toes. People often blame claw toe on wearing shoes that squeeze your toes, such as shoes that are too short or high heels. However, claw toes often are the result of nerve damage caused by diseases like diabetes or alcoholism, which can weaken the muscles in your foot. Claw toes can get worse without treatment and may become a permanent deformity over time.
There are several signs of claw toe:
- Your toes are bent upward (extension) from the joints at the ball of the foot.
- Your toes are bent downward (flexion) at the middle joints toward the sole of your shoe.
- Sometimes your toes also bend downward at the top joints, curling under the foot.
Corns or calluses may develop over the top of the toe, under the end of the toe or under the ball of the foot.
If you have symptoms of a claw toe, see your foot and ankle orthopaedic surgeon for evaluation. You may need tests to rule out neurological disorders that can weaken your foot muscles, creating imbalances that bend your toes. Trauma and inflammation also can cause claw toe deformity.
Claw toe deformities are flexible at first, but they harden into place over time. If you have claw toe in early stages, your doctor may recommend a splint or tape to hold your toes in correct position.
Non-surgical treatments should be tried first to correct claw toe. Wear shoes with soft, roomy toe boxes and avoid tight shoes and high heels. Use your hands to stretch your toes and toe joints toward their normal positions. Exercise your toes by using them to pick up marbles or crumple a towel laid flat on the floor.
If you have claw toe in later stages and your toes are fixed in position, a special pad can redistribute your weight and relieve pressure on the ball of your foot. Try special "in depth" shoes that have an extra 3/8-inch depth in the toe box or ask a shoe repair shop to stretch a small pocket in the toe box to accommodate the deformity.
If the above treatments don't help, you may need surgery to correct the problem. The type of surgery often depends on the severity of the deformity. If the claw toe is still in the early stages or flexible (able to be manually corrected with passive stretching), your foot and ankle orthopaedic surgeon may recommend a procedure to reroute a flexor tendon to the toe to correct the deformity. If the deformity has been present for a long time and is now rigid (not correctable), your surgeon may recommend a toe fusion.
Sometimes your surgeon needs to perform other procedures on the toe to allow it to flatten. These may include bone cuts or tendon procedures.
Contributors/Reviewers: Nicholas Cheney, DO; Hui Zhang, MD; Selene Parekh, MD
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