Causes and risk factors
Claw toe occurs due to alteration in the normal anatomy of the bones. Nerve injury or damage due to certain neuromuscular disorders like cerebral palsy, stroke, and multiple sclerosis can lead to claw toe. An individual suffering from diabetes mellitus or one who is an alcoholic have high risk factors. Trauma and inflammation or tightening of the ligaments and tendons are the other contributing factors. Disease of the bone, particularly arthritis, is one of the leading causes of claw toe.
Clinical presentation:
Claw toe is divided into two types – flexible and rigid type. In rigid type of claw toe, there is restriction of movement. Movement causes pain. While in flexible type there is ability to move. Either second, third, or fourth toe can be affected. The characteristic feature of a claw toe is that the toe is bent. The toe bends down towards the sole. This can lead to formation of callus. Pain and severe pressure are other associated complaints seen. Tenderness is seen on examination.
Investigations:
The local examination of the affected toe is carried out; the symptoms narrated by the patient along with investigations are taken into consideration. Investigations like x-ray can be done to rule out any fracture or bone injury, and MRI can be done to know the extent of injury to the ligaments and surrounding tissues. Neurological tests can be done to rule out other causes.
Treatment:
Application of ice packs to the affected area is advised. Pain-relieving medication or medications to relieve the pain is prescribed. Massaging the area of tenderness will also be effective. Splint or tape is strapped around the toes affected to hold the toes in its normal position. Preferably shoes which have roomy and soft toe boxes should be used, shoes with special pads which will distribute the weight and reduce the pressure. Gel toe caps and shields can be used to reduce the friction between the shoes and the toe. In severe cases, surgical intervention is done. Exercises for increasing the mobility and strength of the muscles are done.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Acupuncture, which is the science of insertion of fine needles at certain stimulating spots on the body has been proven to be effective. Certain yoga exercises can also be helpful in relieving the pain and strengthening the muscles.
