What are the causes of claw toes?

‍As a foot surgeon I am often asked: How do claw toes actually develop? I would therefore like to inform you today about the causes of claw toes. It is also important for me to explain what claw toes are and what symptoms can occur. So, what are claw toes?

Claw toes are a common deformity of the four small toes of the foot. It is a deformity of the small toes in which all toe joints except the metatarsophalangeal joint are permanently and involuntarily bent and the tip of the toe is pointed towards the ground like a claw. This malposition can affect one or both feet. There are a number of causes of claw toes, including ill-fitting shoes, foot malpositions, arthritis, nerve damage and muscle imbalance.

Claw toe usually develops gradually, but can get worse over time if left untreated. Therefore, it is important to recognise the symptoms of claw toe and see an orthopaedic surgeon or foot specialist to avoid permanent damage. Without treatment, the toes can become stiff and lead to severe pain. Foot surgeons usually have a lot of experience with claw toes because they often perform foot surgery for small toe deformities, which claw toe is.

Claw toes can have various causes and triggers. Here are the most important ones that I know from my experience as a foot surgeon:

• Ill-fitting or too tight shoes are a common cause of claw toes as they put pressure on the toes and can force them into a claw-like position.
  
  
• Malpositioning of the foot due to static problems
  • Incorrect stresses that arise due to the foot or body statics can lead to overloading of the toes at the metatarsal bones. This can trigger a shift in the pivot points, which develop into an imbalance of muscle strength at the level of the small joints.
  • If, due to static misalignments, the load is increased selectively at certain points, structures such as the joint capsule or basic joints of the toes can be damaged. This in turn leads to muscle imbalance and thus to a possible malposition of the toes. Sometimes the toes may also experience excessive activity of the flexor muscles because they try to compensate for instabilities elsewhere.
• Claw toes can be due to contractures of the toe flexors which may be caused by damage of these muscles ( compartment syndrome) or neurological diseases

The most noticeable symptom of claw toes

• is the pain at the tip of the toe when the toe "claws" into the ground.
• Furthermore, shoe conflicts of the toe at the toe joint close to the body are pre-programmed due to the typical, claw-like position. In narrower shoes or shoes with soft leather, the curve of the claw toe is clearly visible in the shoe from the outside. 
• The strained and painful areas can manifest themselves in the form of calluses or corns ("clavus") and can also lead to open ulcers ("ulcus" or "ulcers") with or without infection.

Tonio Gottlieb, MD, recommends:

„Calluses and corns can also form on and around the claw toes. If left untreated, the toes can become stiff and bring severe pain. If you notice any deformity on your toes, you should see a foot and ankle specialist early to prevent worse damage."

Small toe deformities can be of various degrees of severity. Claw toes and hammer toes are among the most common deformities of the small toes."

Make an appointment with Dr Tonio Gottlieb, MD now