Claw Toes: Causes, Symptoms, Treatment and Cost

Claw toes are the result of a disorder in which the toes curl inward and bend downward, giving the appearance of a claw.

• Flexible Claw Toes: This type of claw toes is caused by muscles in the feet becoming weakened over time or due to trauma. The result is the toes curling downwards and becoming stuck in that position. People suffering from this condition may experience pain when wearing certain types of shoes, have difficulty walking, and may have difficulty flexing or extending their toes correctly.
• Rigid Claw Toes: Rigid claw toes are much more severe than flexible claw toes as the joints in the toe become rigid and are unable to be flexed or extended correctly. It is usually caused by an injury to the foot, such as a fracture or trauma, which can damage nerves and muscles around the affected joint area. People suffering from this condition often experience extreme discomfort when walking as well as difficulty with footwear selection and activities requiring prolonged periods of standing or walking on their feet.
• Congenital Claw Toes: Congenital claw toe is a condition present at birth before any injury has occurred to the affected area of the foot. In some cases, congenital claw toe can be corrected over time through special exercises, while other times it may require surgery if it impairs function significantly enough or causes extreme discomfort or pain when walking or wearing shoes.

• Common causes include muscular imbalances, arthritis, nerve damage, ill-fitting shoes and genetic abnormality.
• Other potential causes include diabetes, peripheral artery disease and polio.
• Tight or restrictive footwear can lead to claw toes due to excessive pressure on the forefoot being greater than on the toes' natural flexion points, creating an imbalance of muscle forces over time which leads to clawing of the toes.

• Abnormal curling of the toes, especially when standing
• Toes may point downwards, towards the sole of the foot
• Pain in the ball of foot and/or toes when wearing shoes
• Difficulty flexing toes due to tightness in tendons and muscles
• Thickening of skin over affected area; corns or calluses
• Difficulty walking and balancing due to deformed position of toes

• Wear properly fitting shoes: Choose shoes that come in a wide, deep toe box that is comfortable for the foot and toes.
• Practise good foot hygiene: Wash and inspect your feet regularly and keep them dry at all times.
• Exercise the feet: Stretch your feet daily to increase flexibility.
• Use specialised devices or orthotics: Insert arch supports or heel pads into your shoes to help maintain proper alignment between the bones in the foot and toe joints from abnormal motion, reducing bending of the toes by providing extra support while walking and standing adjust laces or straps on shoes to prevent painful pressure points on the tops of toes.
• Reduce usage of footwear which causes claw toe: Avoid using high-heeled, tight-fitting and pointed-toe shoes as they can worsen claw toe significantly over time

• Physical Examination:This is the first step in diagnosing Claw Toes. During this portion of the exam, the physician will inspect each of the toes for any indications of redness, edema, or deformity. They may also check for any pain or tenderness in the affected area.
• X-ray:An X-ray can be used to look for signs of Claw Toes. It can help to identify any fractures or dislocations in the toes that may be contributing to the issue.
• Magnetic Resonance Imaging (MRI):An MRI scan is often used if there is suspicion of an underlying nerve disorder causing Claw Toes such as Charcot-Marie-Tooth Disease or Peroneal Muscular Atrophy. The MRI will provide detailed images of the muscles and nerves surrounding the toes so that a diagnosis can be made.
• Electromyography (EMG):EMG testing is used to measure electrical activity in muscles and nerves to diagnose nerve disorders such as Claw Toes. It can help determine if there is damage to any of the nerves that control movement of the toes, and it can also help predict how well a person will respond to treatment for Claw Toes.
• Blood Tests:Blood tests can be used to rule out any other possible causes of Claw Toes such as infections or diabetes, which could affect how well a person responds to treatment for Claw Toes.

• Pain:Claw toes can cause severe pain or discomfort when the foot rubs against the shoe.
• Difficulty walking:Claw toes can make it difficult to walk normally due to the pressure on the toes and restriction of motion.
• Foot ulcers:People with claw toes can develop breakdown in skin and foot ulcers that can cause infection if not treated properly.
• Arthritis:Long-term claw toe deformity may result in joint malalignment, leading to arthritis and possible foot deformity over time.
• Corns and calluses:Hammertoes and claw toes can rub against shoes, resulting in corns and calluses on feet, which are painful irritations of the skin caused by friction or pressure over a longer period of time.

• Ten minutes of soaking the afflicted foot in warm water with Epsom salt should be done.This helps to loosen up the contracted muscles and tendons.
• Massage the affected toes and feet with medicated oil. This helps to reduce pain and improve blood circulation in the area.
• Perform gentle stretching exercises regularly to stretch the affected muscles and tendons to reduce clawing of toes.
• Apply hot fomentation (warm compress) on the affected area for 5-10 minutes, 3-4 times a day, to reduce pain and inflammation.
• Intake herbal supplements such as ashwagandha, brahmi, shatavari, guduchi etc which help in reducing stress levels that can worsen clawing of toes further

• Eating a balanced diet that is rich in fruits, vegetables, lean proteins and whole grains is important for people with Claw Toes disease.
• Those who suffer from Claw Toes illness may derive some benefit from consuming foods rich in omega-3 fatty acids, such as walnuts, salmon, and mackerel.
• Eating foods that are high in vitamin D and calcium can help strengthen bones weakened by Claw Toes disease.
• Increasing intake of dietary fibre can help reduce symptoms of constipation associated with the condition.

• Avoid fried and fatty foods such as potato chips, french fries, and meats high in saturated fats.
• Avoid sugary foods such as candies, cakes, pies, and processed foods that contain refined sugars.
• Avoid caffeine products such as coffee and tea that may dehydrate your body further.
• Avoid carbonated drinks and sweetened beverages like soda which increase blood sugar and lead to swelling in the feet.
• Avoid alcohol since it is a diuretic which may cause dehydration leading to dropping of the toe joints down resulting in claw toes deformity.

• Orthotic Inserts:Orthotic inserts are designed to fit into shoes and provide additional cushioning, and can also be used to stretch and support the toe muscles, which helps to correct claw toes.
• Stretching Exercises:Regular stretching exercises can help to reduce the pain associated with claw toes, as well as strengthening the muscles in the feet and toes that are needed to correct the deformity.
• Splinting:Splinting is a method of using a brace or splint to keep the toe in a straighter position while sleeping. This helps reduce strain on the toe muscles during sleep, which can help prevent further contracture of the toes.
• Surgery:When the condition is serious enough, surgery may be the only option for completely correcting claw toes.During surgery, tendons around the toes will be released and realigned so that they no longer cause clawing of the toes.

A person suffering from claw toes should consult a podiatrist, who specialises in diagnosing and treating diseases of the foot and ankle.

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These medications help reduce pain, stiffness and inflammation in the muscles, tendons and joints of the feet and toes. Examples include ibuprofen (Advil), naproxen (Aleve) and celecoxib (Celebrex).
• Corticosteroids: These drugs are used to reduce inflammation in the toes and feet. They come as pills or injections (directly into the toe). Examples include prednisone, methylprednisolone, triamcinolone, hydrocortisone acetate, dexamethasone and betamethasone.

The severity of the problem will determine how long it will take for the patient to make a full recovery from claw toes.

Mild cases may resolve within three months with conservative treatments such as stretching, special exercises, custom orthotics, and proper footwear.

More severe cases may require surgery to correct the deformity and could take up to six months or longer for full recovery.

• The results of treatment for claw toes will vary depending on the severity of the problem; nevertheless, in most cases, the issue will not be permanent even after the treatment has been completed.
• Treatment methods often focus on managing symptoms and addressing issues such as pain, inflammation and deformity.
• Surgery is sometimes recommended to correct deformity in more serious cases, but it is not foolproof and may require additional treatments to maintain effects.
• Regular stretching exercises, specialised footwear and splinting may also be recommended to help address symptoms.
• Ultimately though, even with treatment claw toes can become worse over time if not monitored closely.

• It is important to wear shoes that have a wide toe box, low heels, and soft soles.
• Avoid tight-fitting or narrow shoes as these can exacerbate deformities and further reduce the range of motion in the toes.
• Toe splints or taping may be recommended to maintain a better position of the toes during the healing process, while also providing additional support.
• It is also recommended to use orthotic devices or therapeutic footwear with extra padding and cushioning to relieve pressure on the affected toes and minimise any pain associated with this condition.
• Gentle stretching exercises can be used to help improve mobility of affected joints as well as strengthen them with time allowing for greater control over the toes and better grip while walking
• Regularly perform foot care by keeping the feet clean and dry, avoiding excessive exposure to heat or cold, soaking tired feet in warm water, massaging sore parts of feet gently with lotions or cream, wearing comfortable socks/stockings etc., if needed .

In India, the cost of therapy for claw toes varies based on the kind of deformity as well as the severity of the condition. Generally, surgery is done to correct the deformity and can range from INR 15,000 to 20,000 ($200-$300) per foot.

Non-surgical treatment such as orthotics or splints may be suggested but may cost a lesser amount depending on what is needed.

Treatment with physical therapy may also be recommended to address any pain or discomfort related to claw toes and can range from INR 25,000-30,000 per session on average.

The most common side effects of Claw Toes treatments are pain and swelling at the site of the procedure.

Other potential side effects include infection, nerve damage, and recurrence of the condition. In rare cases, complications can lead to amputation of the toe.

Claw toes is a condition in which the toes curl downward, similar to a claw. It is most commonly caused by nerve damage, muscle imbalance, or arthritis. Treatment options include splints and braces to help restore normal alignment of the toes, as well as physical therapy and medications to reduce inflammation and pain.