Claw toes are a contracture downward of the toe and upward where the toe attaches to the foot. They are quite painful and make fitting in shoe gear quite difficult.
When you come to my office and you present with a claw toe, usually what I'll recommend is a change in shoe gear. You want a shoe that has a wider and deeper toe box to prevent any irritation. Some other things I recommend would silicone toe caps as well as a buttress pad. A buttress pad can be made out of silicone or felt. It works nicely at keeping the tip of the toe from rubbing on the bottom of your shoe.
Sometimes patients have pain in the ball of their foot as a result of claw toes, and that's because excessive pressure is being pushed backwards onto the ball of the foot. A metatarsal pad works very well in this case.
Sometimes we'll fabricate a orthotic device to rearrange the pressure on the bottom of the foot. Should conservative therapy fail to alleviate the condition, then surgical alternatives are available. Typically what's involved with repairing a claw toe is to remove bone from the joints of the toe, lengthen the tendon where the toe attaches to your foot, and put a pin in to hold the toe in place.
For people who have claw toes as a result of a neuromuscular disease, typically we'll fuse the joints in the actual toe itself.