Claw Toes

What are claw toes?

Claw toes, as the name implies, are toes bent into an abnormal claw-like shape. The condition usually happens to the four smaller toes of your foot and it’s the middle and end joints (the joints furthest away from your ankle) that buckle.

Claw toes are often associated with a high arched (cavus) foot type, muscle imbalances or occasionally a neurological condition. Ulcers may develop in people with diabetes because of decreased foot sensitivity.

If you don’t get treatment for your claw toes, they may become permanently stiff.

Are claw toes painful? What causes the pain?

Claw toes can cause pain because your toes get pushed down into the soles of your shoes. Corns or calluses may result from the pressure and rubbing on the bottom of the shoe or on the top of the toes. Rarely, infections may occur.

What are the stages of claw toes?

There are two stages:

• Flexible: This is the early stage. Your toes still flex at the joints, although they’re stiff.
• Rigid: This is the late stage where your toes are stuck, unmoving.

Surgery is most effective during the flexible stage.

What’s the difference between claw toes and hammertoes?

Hammertoes are caused by weak muscles. Also, a hammertoe is bent just in the second (middle) toe joint.

What’s the difference between claw toes and mallet toes?

Claw toes have bent middle and end joints while a mallet toe is a bend in just the last joint.

Who is likely to get claw toes?

People with high arches, or those who tend to rotate their feet inward while walking, are susceptible to toe deformities.

Are claw toes hereditary?

Yes, toe deformities can be inherited.

What causes claw toes?

Most of the time an imbalance of foot muscles typically causes claw toes. Specifically, your toe muscles contract too far, tighten the tendons and bend the joints. Foot muscles become unbalanced due to the following factors:

• Genes.
• Ill-fitting shoes.
• Nerve damage caused by diabetes.
• Rheumatoid arthritis or osteoarthritis.
• Nerve damage cause by alcoholism.
• Charcot-Marie-Tooth Disease.
• Spinal cord tumors.
• Polio and cerebral palsy.
• Stroke. The stroke-side foot is affected.
• Trauma.

What are the symptoms of claw toes?

Claw toes are more than just bent toes. Additional symptoms include:

• Corns.
• Calluses.
• Blisters.
• Pain.
• Swelling.
• Ulcers (rare).

What makes claw toes worse?

Your claw toes will get progressively worse with time.

What are corns and calluses?

Caused by pressure and rubbing, corns and calluses are common in people who have claw toes. A bent joint can rub against the inside of a shoe, and so can the bottom of your foot. Corns are small and round and calluses are larger and have a more irregular shape. They may or may not be painful.

How are claw toes diagnosed?

Your healthcare provider will perform a physical examination of your toes, likely touching them to see how they move.

You may be tested for neurological problems. Some neurological disorders can weaken the muscles of your foot, which creates imbalances that bend your toes.

Do I need to see a specialist?

Your primary healthcare provider may refer you to a podiatrist and/or a foot and ankle orthopedic surgeon.

What questions might my healthcare provider ask to diagnose claw toes?

Your healthcare provider may ask the following questions during your appointment:

• When did you start to notice your toes bending?
• Do you have any corns?
• Do you have any calluses?
• Have you tried any at-home treatments?
• Do members of your family have claw toes?
• What’s the cause of your family members’ claw toes?

How are claw toes treated?

There are both non-surgical and surgical treatments for claw toes. Most of them you can do at home. Non-surgical treatments for claw toes include:

• Wearing shoes that have roomy toe boxes, low heels and good arch support.
• Wearing shoes with an increased width and depth, with soft soles and minimal seams in the toebox.
• Wearing pads, arch supports or other shoe inserts to cushion the toe.
• Strengthening and stretching toe muscles through exercises.
• A splint or tape to hold your toes where they’re supposed to be.
• Avoid high heels.
• Avoid tight shoes.

The severity of your claw toes determines what type of surgery you’ll have. Your healthcare provider will categorize your claw toe as early or late stage, either flexible or rigid. Surgical treatments for claw toes include:

• Tendon lengthening and rerouting.
• Shortening the bones of the phalanx.
• Temporarily inserting a steel pin to hold the toe in the correct position until healing occurs.
• Toe fusion.

What exercises can I do?

Simply use your fingers to stretch your toes. Then, exercise your toes by using them to pick things up off the ground. Recommended objects include:

• Towels.
• Marbles.
• Small balls.

Is the surgery outpatient or inpatient?

Your claw toe surgery will be outpatient, meaning that you won’t have to spend a night in the hospital.

What are the risks of surgery?

All surgeries come with risks. Claw toe surgery, specifically, comes with the following risks:

• Nerve injury.
• Stiffness.
• Infection.
• Recurrence. Your claw toes may possibly return after treatment. Ask your healthcare provider about ways to prevent that.

How soon after treatment will I feel better?

About four to six weeks.

Can claw toes be prevented? How can I reduce my risk?

Your healthcare provider may recommend the following:

• Exercise your toes: Stretch your toes out and pick up small objects with your toes.
• Wear sensible shoes: The best shoes if you’re prone to claw toes have good arch support, short heels and an extra wide toebox.
• Pumice stone: Use a pumice stone to file down your corns and calluses.

What’s the outlook for people with claw toes?

If you don’t get treatment, your claw toes may become permanent. That may make walking and running painful and hard. See your healthcare provider as soon as you have symptoms to keep your toe joints from becoming rigid.

Can I live a normal life with claw toes?

Yes, but your claw toes may make walking and running difficult.

How do I take care of myself?

Do your exercises, stretch your toes and don’t hesitate to get surgery if you need it. Follow your healthcare provider’s instructions.

When should I see my healthcare provider?

See your healthcare provider as soon as you notice that you’re having trouble flexing the joints of your toes.

What questions should I ask my healthcare provider about claw toes?

• Do I have claw toes, hammertoes or mallet toes?
• What at-home remedies do you recommend for me?
• What stage are my claw toes in?
• Do you think I need surgery?
• What do you think caused my claw toes?
• What shoes do you recommend?

A note from Cleveland Clinic

Take care of your feet by wearing sensible shoes, filing down corns and calluses and exercising your toes. Remember that it’s important to get treatment as soon as you notice symptoms of claw toes. If you wait too long, they could become inflexible, and you might need surgery. Take care of your feet.