Claw toes, also referred to as claw foot, is a deformity in the projections of the feet characterised by any of the four smaller toes twisted into an irregular claw-like structure, as the term indicates. When it occurs as an isolated condition, it does trigger much pain but is usually a minor case that can be rectified easily. However, in some instances, claw toes suggest underlying health concerns such as diabetes, osteoarthritis or cerebral palsy.
If left unattended, swelling can occur in the bent toes, giving rise to corns, blisters, calluses and sometimes even infection and pus. Moreover, as the condition worsens, the affected toes that are flexible to a certain extent become quite stiff and difficult to move or stretch freely. It is hence advised to report the signs of claw toes to a doctor at once and seek treatment to repair the foot-related defect.
Causes Of Claw Toe:
The primary reason for claw toes is a muscle imbalance in the feet wherein excessive contraction of the toe muscles results in bent joints with an abnormal external structure. Various aspects contribute to foot muscle imbalance, such as:
- Genetic or inherited faults in the feet
- Wearing tight-fitting shoes, high heels regularly or for long durations
- Diabetic neuropathy that affects the nerves and muscles in the feet
- Debilitating ailments such as osteoarthritis and rheumatoid arthritis
- Hereditary motor neuropathies like Charcot-Marie-Tooth disease
- Stroke and trauma
- Spinal cord tumours
- Cerebral palsy
Individuals who have very prominently arched feet are prone to acquiring claw toes. Moreover, people who walk in an unusual manner with their feet turned inward also face a higher chance of developing a claw toe owing to constantly applying pressure in the bowed toe muscles and joints.
The defining symptom of claw toes is considerable pain in the front portion of the feet as well as all along the heels, like in turf toe, due to persistent tension on the bent toes while standing or walking, which presses them against the soles of the footwear or on the floor/ground if walking barefoot.
Claw toe progresses in two distinct stages:Flexible:
This is still the initial stages of the condition wherein the affected toes can be flexed around the joints, with only minimum stiffness.Rigid:
As the early stages of claw toe conclude and the ailment advances in intensity, the rigid or late stage sets in. In this case, the affected toes are hinged firmly at the joints and are inflexible, fixed, with no movement.
The doctor conducts a thorough physical examination of all the toes in both feet, checking to see how easily they are able to move. The healthcare provider also inspects the feet for signs of corns, calluses, blisters to determine if any inflammation or infection has surfaced due to additional friction and pressure in the affected toes.
If a pre-existing disorder is prompting claw toes, then a foot specialist – podiatrist as well as an orthopaedic doctor assess the symptoms in the patient to gauge if diabetes, arthritis or neurological illnesses are the cause of aberrantly bent toes. The medical expert also questions the patient about any family history of claw toes to find out if inherited gene defects are the reason for the foot defect.
Depending upon the severity and stage of claw toes, treatment involves both non-surgical remedies and surgical procedures. The doctor advises the patient to practice non-surgical treatment measures of wearing comfortable footwear with enough space to accommodate and move all toes, avoid donning high heels and tight footwear. The physician also recommends opting for shoes with optimal arch support and soft soles to reduce pressure on bent toes, utilising shoe inserts to protect the toes and affixing tape or splint to retain the toes in the right position. Exercises to strengthen the affected muscles, bones and joints are also advised by the medical professional to improve flexibility in the affected toes.
Invasive surgical procedures to mend claw toes comprise shortening the bones of the phalanx i.e. toes, tendon lengthening and rerouting, toe fusion and insertion of steel pins. These protocols assist in resolving claw toes and alleviating pain and discomfort in the forefoot and heels.