Overlapping toes is usually a congenital deformity that causes one toe to lie on top of another toe. It most often occurs with the little toe, but the middle toes can also be affected. Sometimes overlapping toes develop as the result of other foot conditions. High arches and flat feet (two conditions that change the way children distribute weight on their feet) often lead to little toe being pushed up on top of its next-door neighbor.

Ill-fitting shoes can sometimes lead to the deformity in adults. If a person consistently wears a shoe with a narrow toe box, the toes will be squeezed together and forced to overlap. Overtime, this positioning of the toes can become permanent so that even when going barefoot the toes are frozen in this unnatural condition. Bunions (big, bony protrusions that develop at the base of the big toe) can also lead to the overlapping of the other toes. The bunion pushes the big toe inward, and the other toes are forced to compensate sometimes by sitting on top of each other.

Complications of overlapping toes include pain, irritation of the skin as well as blisters and calluses forming between and on the tops of the toes. The joints and bone structure of the toes become altered.

Most podiatrists recommend non-surgical treatments. The first step is to accommodate the deformity. This means shoes should have wide and deep toe boxes that will help to reduce pressure and friction on the toes. Sometimes podiatrists recommend simple orthotics such as gel toe caps, toe combs or toe straighteners that help to keep the toe in its proper position.

When the deformity is congenital, treatment can begin very early in a child’s life. Stretching and taping of the toes is common during infancy. This, of course, does not guarantee that the deformity will be corrected. In fact, full correction of the deformity rarely happens. The goal is to correct the deformity as much as possible while the child is still a stage of development and the deformity is not yet fixed. In rare cases, surgical treatment is required. A podiatrist will release a tendon and soft tissue at the base of the affected toe. If the deformity is severe, a pin may be used to hold the toe in the corrected position. This pin will remain in the toe for approximately three weeks. Once it is removed, the affected toe may need to be splinted.