The most defining sign of a claw toe or a claw foot is the abnormal position of the toes. A claw toe is so named because the toe bends at the second knuckle (the middle/proximal phalanx joint) and the first knuckle (distal interphalangeal). The toe is bent in such a way that it may actually curl under itself. Tarsal tunnel syndrome is an unusual form of peripheral neuropathy. It occurs when there is damage to the tibial nerve. The area in the foot where the nerve enters the back of the ankle is called the tarsal tunnel. This tunnel is normally narrow. When the tibial nerve is compressed, it results in the symptoms of tarsal tunnel syndrome. Pressure on the tibial nerve may be due to any of the following.
What is Morton’s neuroma?
Morton’s neuroma affects your forefoot or ball of your foot, between the metatarsal bones and toes. It’s also called intermetatarsal neuroma. When you have Morton’s neuroma, the nerve between the bones of your toes may become swollen and inflamed. You usually feel it on the bottom of your foot, between your toes. The neuroma can feel painful and make it hard to walk. Cat 312 b service manual.
Getting treatment for Morton’s neuroma is important. The neuroma can become larger without treatment. The nerve damage may become permanent.
Why Do My Toes Curl
Is Morton’s neuroma a tumor?
The “neuroma” in Morton’s neuroma is slightly misleading. Neuromas are noncancerous (benign) tumors found on nerves throughout the body. They involve a growth of extra nerve tissue.
With Morton’s neuroma, there’s no growth and no tumor. Instead, the existing tissue around the nerve becomes inflamed and gets bigger.
Where does Morton’s neuroma happen?
Usually, the neuroma happens between the bones of your third and fourth toes. Those are the two toes closest to the pinky toe (toe No. 5). But Morton’s neuroma can form between the second and third toes as well.
You develop the condition when the nerve suffers excessive pressure or compression between the toes. That compression (squeezing) causes inflammation and irritation.
Who gets Morton’s neuroma?
You may face a higher risk of developing Morton’s neuroma from:
- Foot shape: If you were born with flat feet, high arches or toes in an unusual position, you might have instability around the toe joints. That instability can lead to Morton’s neuroma.
- Certain medical conditions: Some foot conditions that develop over time can raise your risk of developing Morton’s neuroma. Examples include bunions and hammertoes.
- Sports: Sports such as running, tennis and other racquet sports require a lot of pressure on the balls of your feet as you run. Athletes are also more likely to injure their foot, which can lead to Morton’s neuroma.
- Shoe choice: High heels (more than 2 inches high) can cause problems. So can tight-fitting, narrow or pointed-toe shoes. All these shoes put extra pressure on the balls of your feet and limit toe movement.
How common is Morton’s neuroma?
About 1 in 3 people have Morton’s neuroma. It occurs more often in women than men, likely because of shoe styles. Women are about 8 to 10 times more likely than men to develop Morton’s neuroma.
What causes Morton’s neuroma?
An irritated or damaged nerve between the toe bones causes Morton’s neuroma. You feel it on the ball of your foot. Common causes of the nerve reacting this way include:
- Being born with a congenital foot problem.
- Pressuring the ball of the foot while running during certain sports.
- Wearing shoes that prioritize style over support.
What are the symptoms of Morton’s neuroma?
You may not see noticeable signs of Morton’s neuroma on your foot. Since it’s not a tumor, you won’t see a lump, for example. You may feel some pain at first, though it tends to start slowly. In the beginning, you can often improve your symptoms by taking your shoe off and massaging your foot.
Symptoms of Morton’s neuroma get worse over time. These symptoms include:
- Sharp, stinging or burning pain between the toes when you stand or walk.
- Swelling between the toes.
- Tingling (feeling pins and needles) and numbness in your foot.
- Sense there’s a bunched-up sock or small rock under the ball of your foot.
- Pain that’s worse when you wear high-heeled shoes or stand on the balls of your feet.
Tarsal tunnel syndrome is a condition in which the tibial nerve is being compressed. This is the nerve in the ankle that allows feeling and movement to parts of the foot. Tarsal tunnel syndrome can lead to numbness, tingling, weakness, or muscle damage mainly in the bottom of the foot.
Tarsal tunnel syndrome is an unusual form of peripheral neuropathy. It occurs when there is damage to the tibial nerve.
The area in the foot where the nerve enters the back of the ankle is called the tarsal tunnel. This tunnel is normally narrow. When the tibial nerve is compressed, it results in the symptoms of tarsal tunnel syndrome.
Pressure on the tibial nerve may be due to any of the following:
- Swelling from an injury, such as a sprained ankle or nearby tendon
- An abnormal growth, such as a bone spur, lump in the joint (ganglion cyst), swollen (varicose) vein
- Flat feet or a high arch
- Body-wide (systemic) diseases, such as diabetes, low thyroid function, arthritis
In some cases, no cause can be found.
Symptoms may include any of the following:
- Sensation changes in the bottom of the foot and toes, including burning sensation, numbness, tingling, or other abnormal sensation
- Pain in the bottom of the foot and toes
- Weakness of foot muscles
- Weakness of the toes or ankle
In severe cases, the foot muscles are very weak, and the foot can be deformed.
Your health care provider will examine your foot and ask about your symptoms.
During the exam, your provider may find you have the following signs:
- Inability to curl the toes, push the foot down, or twist the ankle inward
- Weakness in the ankle, foot, or toes
Tests that may be done include:
- EMG (a recording of electrical activity in muscles)
- Nerve conduction tests (recording of electrical activity along the nerve)
Other tests that may be ordered include blood tests and imaging tests, such as x-ray, ultrasound, or MRI.
Treatment depends on the cause of the symptoms.
- Your provider will likely suggest first resting, putting ice on the ankle, and avoiding activities that cause symptoms.
- Over-the-counter pain medicine, such as NSAIDs, may help relieve pain and swelling.
- If symptoms are caused by a foot problem such as flat feet, custom orthotics or a brace may be prescribed.
- Physical therapy may help strengthen the foot muscles and improve flexibility.
- Steroid injection into the ankle may be needed.
- Surgery to enlarge the tarsal tunnel or transfer the nerve may help reduce pressure on the tibial nerve.
Why Do My Toes Crack When I Curl Them
A full recovery is possible if the cause of tarsal tunnel syndrome is found and successfully treated. Some people may have a partial or complete loss of movement or sensation. Nerve pain may be uncomfortable and last for a long time.
Untreated, tarsal tunnel syndrome may lead to the following:
- Deformity of the foot (mild to severe)
- Movement loss in the toes (partial or complete)
- Repeated or unnoticed injury to the leg
- Sensation loss in the toes or foot (partial or complete)
Call your provider if you have symptoms of tarsal tunnel syndrome. Early diagnosis and treatment increases the chance that symptoms can be controlled.
Tibial nerve dysfunction; Posterior tibial neuralgia; Neuropathy - posterior tibial nerve; Peripheral neuropathy - tibial nerve; Tibial nerve entrapment
Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 107.
Why Do My Toes Crack When I Curl Them
Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 420.
Why Do My Toes Crack When I Curl Them
Updated by: Alireza Minagar, MD, MBA, Professor, Department of Neurology, LSU Health Sciences Center, Shreveport, LA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.