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Conditions of the lesser toes can be caused by internal or external factors. Lesser toes refer to all of the toes (2nd, 3rd, 4th and 5th) except for the big toe.

Causes

• Improper and/or ill-fitting footwear
• Neuromuscular factors
• Peripheral neuropathy caused by diabetes or leprosy
• Rheumatoid or psoriatic arthritis
• Trauma
• Muscle imbalance

Types of Lesser Toe Conditions and Symptoms include:

• Claw Toe Deformity – deformity where both the 1st and 2nd joints within the toes are permanently flexed. Pain in the ball of the foot and painful corns may occur on the top of flexed joints or underneath the tip of the toe
• Hammer Toe Deformity – deformity where only the 1st toe joint is flexed. An irritation or corn is often seen on the top of the joint, or under the tip of the toe
• Mallet Toe Deformity – deformity where the last joint in the affected toe is flexed. Pain and/or a corn may develop over the top of this joint and possibly under the tip of the toe

• Foot and lower limb exam
• Custom-made foot orthotic or over-the-counter device
• Modification of footwear
• Recommendation of appropriate and proper fitting-footwear
• Toe spacers or padding

To alleviate the pain caused by lesser toe deformities, Canadian Certified Pedorthists recommend selecting footwear with:

• Wide, deep, square toe box to allow proper room for toes and alleviate pressure
• Toe box without stitching to avoid irritation
• Rocker soled shoes (where toe part curves up from the ground) to decrease stress and pressure on the ball of the foot
• Where required, Canadian Certified Pedorthists will also spot stretch areas where the shoe rubs to minimize discomfort and potential irritation
• A custom-made foot orthotic can be created to reduce pain and pressure on specific areas such as the ball of the foot
• Padding can also be used to protect painful corns and calluses.