Lesser Toe Deformities

What are Lesser Toe Deformities?

Lesser toe deformities are changes in the shape of any of the four smaller toes on your foot. These changes can cause pain or discomfort, especially when wearing shoes. They are most common in the second toe but can affect any of the smaller toes, causing them to claw, curl, or overlap.

Types of Lesser Toe Deformities:

Hammer Toe:

The middle joint of the toe bends down, causing a corn or callus to form on the top or tip of the toe. This is most common in the second toe but can happen to any smaller toe. If untreated, it can become fixed in this position.

Claw Toe:

Both the middle and end joints of the toe bend down, causing pain and calluses or corns on the top or tip of the toe. If untreated, the deformity can worsen over time.

Mallet Toe:

The end joint of the toe bends down, causing pain and calluses or corns on the top or tip of the toe. If untreated, it can become fixed in this position.

Overlapping Toe:

One toe overlaps another, often seen with bunions but can also affect the fifth toe. This can cause discomfort and calluses where the toes rub together.

What are the signs and symptoms of Lesser Toe Deformities?

You may experience any or all the following:

• Pain and callous and/or corns over the top of the joints of the toes
• Deformity in the shape of toe
• Shoes becoming uncomfortable over the toes
• Pain and callous underneath the tip of the toe
• Redness and swelling around the joint
• Stiffness in the joints of the toe
• Difficulty walking

What causes Lesser Toe Deformities? 

The change in the shape of your toes occurs because of an imbalance between the muscles and tendons which hold your toes straight and those that bend the toes. There can be several reasons for these changes:

• Ill-fitting footwear
• Inflammatory conditions (e.g. rheumatoid arthritis)
• Trauma
• Hallux Valgus (Bunions)
• Neuromuscular conditions e.g. Charcot-Marie- Tooth, Muscular Sclerosis
• Peripheral neuropathy leading to a muscle imbalance

What can help with Lesser Toe Deformities?

To improve comfort, you need to relieve the pressure on the toes and there are several ways you can do this yourself.

Making changes to your lifestyle as well as reducing aggravating activities is key to helping your recovery. Only you can do this.

There are a few things you can try including:

• Rest and raise your foot on a stool when you can
• Put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours
• Wear shoes with cushioned heels and good arch support
• Use insoles in your footwear
• Try regular stretching and foot exercises
• Try exercises which put no pressure on your feet, such as swimming
• Try to lose weight if you are overweight or obese

Try to avoid:

• Walking or standing for long periods
• Wearing high heels and tight pointy shoes
• Wearing flip-flops or backless slippers
• Walking barefoot on hard surfaces

Footwear

It is important that you choose footwear that is deep enough to accommodate toe deformities. It can also be useful to choose a shoe that has a softer material as the upper. Softer materials can mould around the toes more easily than hard patent leathers.

If your shoe is not deep enough, it will rub on the prominent joints causing the surrounding skin to become red, swollen and in some cases the skin can blister or become thickened. Sometimes a fluid filled sac, called a bursa, can develop over the joint. The bursa can also become inflamed and painful.

Strapping

Strapping/taping can be used to help support your toe to help guide improved position and stability. This can be a useful short-term treatment that can help reduce your symptoms. The aim of this low dye taping is to help stabilise and heal the plantar plate ligament after a sprain or injury.

The tape used for this is a rigid strapping called zinc oxide tape. It is available in most pharmacies and can also be bought online.

Taping is only a short-term treatment, and we recommend it is used until your pain levels decrease.

We advise that each application of the tape is kept in place for a maximum or 3 to 4 days. You may find that the tape needs to be replaced more frequently for it to remain effective.

Before you start it can sometimes be helpful to have your strips of tape pre-cut. To get the correct length of tape you can use your hand as a reference. Starting at the tip of your longest finger run the tape to the base of your palm. This should give you the correct amount or tape. Next cut the tape lengthwise into 2 equal sized pieces. Take one of the pieces and stick it back on the roll for later.