Fourth toe tucking under third and always very painful.

My toes are like that, too.
They've fallen sideways and gone triangular over the years, as they are undet the adjacent toe.

Sometimes I'm very aware that I've a big old lump of a woman standing on them, too.

Yes mine is triangular and the nail touches the ground (inside the shoe). My current chiropodist suggested trying to see a consultant in the local private hospital, but I’m put off by the thought of the cost, and I don’t think I’d have surgery at eighty three.

I have a stretchy cap I bought from Amazon that stops my bent over toe rubbing on the ground. It helps a bit.

Fourth toe tucking under third and always very painful
- I'm not sure what this means exactly as my 4th toes aren't really big enough to tuck under my third ones...

I can cross my big toe over the next one but the others (even with arthritis) seem to stay in a row...

Are your toes very long maybe?

I'm sorry you have painful feet though.

My fourth toe leans over and covers part of my big toe to the extent that the big toenail is being pushed down..
Hospital doesn’t want to do anything about it 🤷‍♀️

What a lot of things can go wrong with toes - I’m sorry for all your pain and I will look for the stretchy cap on Amazon.

Hooves would be a bettet idea, I'm sure.
There's so much to go awry with toes.

chickenlegs I think you should see an orthopaedic surgeon and he may suggest fusion of that toe. Possibly surgery is all that can help you, but I may see an orthopaedic surgeon privately for advice, but I wouldn't have surgery there because of the cost and lack of free aftercare. It would probably be around £5K depending on where you live. I agree re your age.

amzn.eu/d/00c9VZcM

This might be worth a try.
There's a little video at the end of the pictures.
Two pairs in the pack and returnable if they don't suit.

Charleygirl5 I also fear that surgery may be the only answer. Thank you for your advice. I am a carer for my husband and couldn’t be unable to drive for however long recovery took.
V3ra thank you, I’ve sent for the toe caps for a start.

I think you would have problems walking up to 3 months unless you were exceptioanlly lucky. You would not be allowed to drive legally until at least you could get proper shoes on and from ex professional experience this can take 6 weeks unless lucky but at our age nothing heals as if we were 50 years younger.

I would return to your GP and get him to sort it out. You shouldn't be spending money "in case it works". My brain is blank as I cant work out who could help you.

I have tried yo understand this problem but have resorted eventually to AI. This version of AI is American so excuse spellings!!

This is what it suggests:
​1. A Custom Silicone Orthodigital Device (The Modern Separator)
​^Since your old separator broke, you need a replacement. Instead of buying cheap, generic gel wedges from a pharmacy (which often slip out of place or don't fit right), you can ask a podiatrist to mold a custom silicone toe orthosis directly to your foot. They mix a putty that cures right on your toes, creating a perfect, durable separator that props the third toe up and keeps the fourth toe straight.^

2. Budin Toes / Toe Straightening Sleeves
​These are elasticated bands or small pads that sit under the ball of your foot with a little loop that goes over the tucked toe. When you tighten the loop, it physically pulls the tucked toe upward and straight, keeping it from diving under its neighbor.

3. Tenotomy (A Simple, Permanent Fix)
​If you want a permanent solution so you never have to worry about separators again, ask a podiatrist or foot surgeon about a flexor tenotomy.
​This is a very simple, 10-minute in-clinic procedure done under local anesthetic. The practitioner makes a tiny pinprick poke under the toe and releases the tight tendon that is pulling the toe downward. The toe instantly relaxes, flattens out, and stops tucking under. There are usually no stitches required, and walking recovery is immediate.

When you look for your next foot care professional, look for a Podiatrist rather than a traditional chiropodist, and ask specifically about structural solutions.
​When you book, say: "I have a painful underlapping fourth toe that tucks under the third. I need an appointment to look at a custom silicone separator or to discuss a tendon release (tenotomy)."

I do hope thus helps. If ig were me with this problem I'd definitely be drawn to the Trnotomy option.
I'd want to research it of course but the idea of immediate release sounds extraordinary and blissful.
All the very best.