Curly toes

Congenital curly toes are a common condition that tend to affect the 3rd, 4th and 5th toes of one or both feet, usually present at birth but can become more noticeable when a child starts walking.

Curly toes are a normal variant and generally don’t require treatment unless they are symptomatic. They generally do not cause any problems. Occasionally the tendons can become tight and pull the tip of the toe underneath the next toe and towards the sole of the foot. Children complain of rubbing or pain and may have problems with finding suitable shoes that fit properly.

Curly toes
Action Descriptions
Key Assessment points
  • Check passive range of motion of the toes, will they fully correct to a neutral position and is there any tightness in the toe flexor tendons?
  • Check for generalised muscle tightness particularly in toe flexor tendons and calf complex (silfverskiold test
  • Check for ‘clawing’ toes or cavus feet
Referral not indicated
  • Overriding toes are flexible/correctable
Refer to Paediatric Physiotherapy
  • There is associated muscle tightness and/or weakness that is exacerbating the problem
Refer to Paediatric Orthopaedics
  • Refer curly toes that are not passively correctable to a neutral position and causing painful blisters or rubbing, callouses or ingrowing infected toe nails possibly requiring surgical intervention
Refer to Community Paediatrician or Neurologist
  • If all of the toes of one or both feet are clawed, resulting in a cavus foot this requires further investigation
Refer to Community Podiatry Service
  • If curly toes are significant refer for consideration of toe props/wedges

 

Where should you seek help?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area  – telephone your child’s school to ask for the contact details of your school nursing team.

There is also a specialist nurse who works with families who choose to educate their children at home.

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

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