Claw toe deformity is a condition that affects the 4 smaller toes of the foot giving them a curled, claw-like appearance. This occurs because the toes bend upward at the base joints, then point down at the middle joints. The big toe is not affected in this disorder.
Claw toes can be caused by congenital factors, neuropathy (nerve damage), rheumatoid arthritis, osteoarthritis, or cerebral palsy. They can also result as a consequence of lifestyle factors, including alcoholism and the use of constrictive footwear, like high heels.
Patients can either have flexible or rigid claw toes. In flexible claw toe, the toes can be manually straightened without pain. In rigid claw toe, there is much less range of motion and it is difficult to uncurl them without discomfort.
Patients with claw toes are initially treated with conservative methods: change in footwear, exercises for the foot, and the use of custom orthotic devices to support natural foot position. Severe cases can be treated with a surgical procedure to realign the toes correctly.