Claw Toes

What Is Claw Toe?

Claw toe is a deformity, where a toe bends and appears like a bird’s claw. The affected toe is bent upward from the joint at the ball of foot, and downward at the joints in the middle and tip of the toe to curl under the foot.
A sample photo of a claw toe
Hard thick skin called corns may develop under the ball of the foot or on the top of the affected toe, causing pain while walking.

Who Does Claw Toe Affect?

Claw toe usually affects 2 – 20% of the population, with most cases seen in elderly people aged 70 years or above.


Women are four to five times more likely to experience claw toes, in part due to the culture of wearing high heels and tighter shoes.


It is also more common in people suffering from diabetes or alcoholism, both of which result in nerve damage.

How Does Claw Toe Occur?

Claw toe results when there is an imbalance between the intrinsic and extrinsic muscle systems of the toes, resulting in altered anatomy.

This can be due to external force or weakened muscles and nerve damage.

Causes of Claw Toe

Curling of the toe under the foot can be affected when the toe is bent upward from:
  • The joint at the ball of the foot, and
  • Downward at the joints in the middle and tip of the toe
Claw toe can occur in the four toes other than the big toe due to nerve damage, which weakens the muscles.

They may be present at birth or acquired later due to other disorders such as:
  • Rheumatoid arthritis, 
  • Cerebral palsy, and
  • Brain injury. 
Women are affected more often than men since claw toe can also form by wearing very tight or high-heeled shoes.

Stages of Claw Toe

The claw toe will slowly progress over time, and increase in prominence and severity accordingly, till it becomes permanent.

How Is Claw Toe Treated?

Conservative Treatment

Claw toe is first treated conservatively with:
  • Regular stretching of the toe and toe joints, 
  • Wearing soft comfortable shoes with a broader toe box,
  • Splinting or taping to hold or align the toes in the correct position.

Surgery

When conservative treatment does not relieve symptoms, the doctor may suggest surgical correction of the toe.

What if Claw Toe Is Untreated?

If left untreated, the claw toe can result in both 
  • Permanent cosmetic and 
  • Physiological deformities, 
This may result in pain and changed gait. In cases of underlying diseases such as diabetes, they need to be treated as well to reduce further deterioration of health.
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