Lesser toes play an important role in foot (and body) locomotion. Despite the high incidence of lesser toe disorders, their conservative treatments have rarely been studied. This study focuses on the conservative management of lesser toe deformities and will try to provide the reader with an overview on the portfolio of shoe modifications and orthotics available for the conservative treatment of lesser toe deformities, indication of each specific type of device, how they can impact on pain relief, and the rationale after considering conservative management as a first line of treatment and potentially avoiding surgery.