Claw Toes : Deformity of the foot
The foot is a highly mechanical apparatus, made of many bones and other
coordinated structures. The foot carries the entire weight of the body and
propels us forward when we stand, walk, and run. Deformities of the toes like,
claw toe, can often cause pain and a loss of function in the use of the foot.
Failure to treat these condition may contribute to the development of serious
and disabling changes in habitual ways of walking and carrying the body. A claw
toe is a toe that is contracted at the PIP and DIP joints, and can lead to
severe pressure and pain. Ligaments and tendons that have tightened cause the
toe’s joints to curl downwards. Claw toes may occur in any toe, except the big
toe. There is often discomfort at the top part of the toe that is rubbing
against the shoe and at the end of the toe that is pressed against the bottom of
Claw toes are classified based on the mobility of the toe joints. There are two
flexible - In a flexible claw toe, the joint has the ability to move. This type
of claw toe can be straightened manually.
Rigid - A rigid claw toe does not have that same ability to move. Movement is
very limited and can be extremely painful. This sometimes causes foot movement
to become restricted leading to extra stress at the ball-of-the-foot, and
possibly causing pain and the development of corns and calluses.
Claw toes result from a muscle imbalance which causes the ligaments and tendons
to become unnaturally tight. This results in the joints curling downwards.
Various neurological condition that can lead to claw toes are:
Spinal cord tumors
The tightening of the ligaments and tendons of the toe, causes a buckling of one
or more joints of the toe. The result is a cocking of the toe upward, whereas in
a normal foot, the toes lie flat.
Shoes can then rub on the top of the cocked
toe, eventually causing painful corns or calluses.
If the deformities are not
treated, the toe may become permanently fixed and rigid.
In claw toe, all of the
toes tend to be affected, not just one or two.
Symptoms of Claw Toe?
The main symptom is pain. There will also be an obvious claw-shaped deformity to
the affected toes, in addition to pain and calluses caused by the upper part of
the toes rubbing against the shoe. Corns or calluses may also develop on the tip
of the toes from pressure and rubbing on the bottom of the shoe. Patients may
find it difficult finding shoes that do not cause pain, and infections may
develop as a result. Ulcers may develop in patients with diabetes because of
decreased sensitivity in the foot.
Treatment and Prevention
Changing the type of footwear worn is a very important step in the treatment of
claw toes. When choosing a shoe, make sure the toe box (toe area) is high and
broad, and can accommodate the
claw toes. A shoe with a high, broad toe box will
provide enough room in the forefoot area so that there is less friction against
the toes. Other conservative treatments include using forefoot products designed
to relieve claw toes, such as toe crests and hammer toe splints. These devices
will help hold down the claw toe and provide relief to the forefoot. Gel toe
shields and gel toe caps are also recommended to eliminate friction between the
shoe and the toe, while providing comfort and lubrication. If the problem
persists, consult your foot doctor.
with soft and roomy
Strengthening toe muscles exercises, such as picking up marbles
with the toes and stretching exercises
Stretch the upper part of the shoe to help accommodate a fixed claw toe
Wear soft pads in the shoe over the corns or calluses.
If the claw toe condition is rigid (inflexible, fixed), surgery may be required,
with a goal of realigning the toe. Procedures may include:
Cutting, lengthening, or repositioning tendons, or shortening the bone
Insertion of a steel pin to fix the corrected position of the toe.
Any forefoot problems causing pain or discomfort should be given prompt
attention. People who experience problems with their feet should seek advice
from an experienced physician or podiatrist who can evaluate the risks,
benefits, and possible complications of various treatment options. Patient
compliance is particularly important in the treatment of these conditions.
Conservative treatment starts with accommodating the deformity. The goal is to
relieve pressure, reduce friction, and transfer force from the sensitive areas.
If surgery is recommended, it is important to fully understand and follow the
recommendations of the surgeon before and after the procedure