Toe pain has several causes, from injuries to chronic health conditions and joint deformities. Most causes of toe pain are not serious and can be managed with conservative treatment. However, pain can significantly affect your ability to bear weight through your toes which can limit your ability to comfortably stand and walk.
This article will discuss common causes of toe pain, how it is diagnosed, treatment options, and when to see a healthcare provider for toe pain.
Causes
Different causes of toe pain can produce symptoms like redness, swelling, stiffness, tingling, and limited range of motion. Some causes of toe pain will come on suddenly while others develop gradually over time.
Osteoarthritis
Osteoarthritis, also called degenerative joint disease, is a condition that causes pain, stiffness, and inflammation of joints from the breakdown of cartilage.
Osteoarthritis can affect any joint but is more likely to affect the big toe rather than the other four toes. Osteoarthritis tends to develop over time from wear-and-tear-related changes with aging, but can also develop faster after an injury.
Gout
Gout is an inflammatory form of arthritis where crystals deposit into joints due to high levels of uric acid in the body.
Gout causes joint pain, redness, and swelling, most commonly in the big toe joint. Shellfish and alcohol can increase gout attacks, so it's best to avoid eating these foods if you have symptoms of gout.
Foot Deformities Listed by Age Group
Turf Toe
Turf toe refers to a hyperextension sprain of the big toe with loading to the joint from weight bearing that happens when the foot pushes off from the turf.
It was first diagnosed in the 1970s and named for the American football players who seemed to get it frequently. However, turf toe can occur in many different sports and activities, though mostly in athletes playing on artificial turf, which is more rigid and has less “give” than natural grass.
Turf toe can result from one forceful push-off from the turf or over time from repeated stress to the big toe joint.
Fractures
A broken bone (fracture) can occur in any of the toes. Toe fractures cause significant pain, bruising, swelling, difficulty moving the toes, and trouble bearing weight on the toes when standing or walking.
Sesamoiditis
The sesamoid bones are small oval bones that are embedded in a tendon to improve the tendon’s line of pull. The tendon of one of the muscles that cause bending (flexion) of the big toe (flexor hallucis brevis) has two sesamoid bones located near the big toe joint.
The big toe endures a lot of pressure with movement like running and jumping, so repeated activity can cause pain and inflammation of the sesamoid bones. This condition is called sesamoiditis.
Sesamoiditis is more likely to occur in people wearing poor footwear and in people with altered foot alignment, such as flat feet or a club foot.
Bunion
A bunion is a foot deformity that causes the big toe to deviate in toward the other toes. Bunions are most often caused by wearing tight shoes that compress the toes, but genetics also plays a role.
Bunions can be painful, and the altered alignment of the big toe joint can make walking uncomfortable.
Corns, Calluses, and Blisters
Corns and calluses are areas of hard and thickened skin that can develop on the feet and toes from repeated rubbing, friction, or pressure. Corns are small, hard areas of skin typically overlying bony parts of the foot while calluses are larger patches of toughened skin. Blisters form when repeated pressure and friction cause fluid to build up under the skin.
Corn, calluses, and blisters on the toes often develop from wearing poorly fitting shoes, prolonged walking, or walking barefoot. They can cause pain when standing and walking.
Ingrown Toenails
Ingrown toenails occur when the edges or corners of the toenails grow into the skin next to the nails. Toe injuries, tight footwear, poor foot hygiene, and genetics can increase the likelihood of developing an ingrown toenail. Ingrown toenails can cause redness, swelling, pain, and sometimes bleeding and infections.
Claw and Hammer Toes
Toe deformities are a frequent cause of toe pain. Claw toes are when the proximal interphalangeal (PIP) joint and distal interphalangeal (DIP) joint bend down. Hammer toes refer to when just the PIP joint bends down.
Claw toes and hammer toes are more likely to develop in adults in their 40s and 50s, as well as in people with bunion deformities, inflammatory forms of arthritis, and prior foot and toe injuries.
Dactylitis
Dactylitis refers to swelling of the fingers or toes that creates a sausage-like appearance. Dactylitis is most often associated with psoriatic arthritis, an autoimmune inflammatory form of arthritis that develops in people with psoriasis, an inflammatory condition of the skin. Dactylitis causes toe and finger redness, swelling, and pain.
Peripheral Neuropathy
Peripheral neuropathy results from damage to the nerves of the arms, hands, fingers, legs, feet, and hands. It causes symptoms like numbness, tingling, burning, decreased sensation, and pain.
Damage to the nerves of the peripheral nervous system can result from injury, diabetes, Guillain-Barre syndrome, peripheral vascular disease, infections, or as a side effect of chemotherapy treatment.
Causes of Hand and Foot Pain
When to See a Healthcare Provider
Minor issues that can cause toe pain, especially if you were walking for a long time and/or wearing tight or uncomfortable shoes, typically resolve in a few days. If your toe pain persists longer than a week, contact your healthcare provider. They can determine the underlying cause and help you get started with the appropriate treatment.
Certain signs and symptomsindicate you need to schedule a visit to see a healthcare provider:
- Your pain significantly impacts your ability to stand or walk
- You cannot move your toe without pain
- Your toe is red, hot, or swollen
- You lose sensation in your toe
- You have other symptoms such as fever, fatigue, or unexplained weight loss
Diagnosis
To diagnose the cause of your toe pain, a healthcare provider will perform a physical exam and ask you about your medical history, including how and when your symptoms began.
Depending on the nature of your condition, your provider may want to do imaging or blood tests to help them determine the underlying cause of your toe pain.
Medical History
During a visit with your healthcare provider, they will review your medical history. This will include going over any medical conditions you have and discussing how and when your toe pain began.
Your healthcare provider will also ask you questions about your condition, such as:
- Are you experiencing any other symptoms besides pain, such as tingling, numbness, swelling, burning, or muscle weakness?
- Has the pain been getting worse over time?
- Does the pain occur at rest or only when you stand or walk?
- Did you injure or previously injure your foot or toes?
Tell your healthcare provider if you recently had an infection or have unusual symptoms like fever, fatigue, or unexplained weight loss. These factors could suggest that there is an atypical systemic condition causing your toe pain.
Physical Examination
After reviewing your symptoms and medical history, your healthcare provider will do a physical exam to look at your foot and toes. They will inspect and touch your foot and toes and move your toe joints to see if your motion is restricted and/or painful.
During your physical exam, your healthcare provider will look for signs of:
- Redness
- Warmth
- Swelling
- Tenderness
- Bruising
- Numbness
- Abnormal skin texture
Blood Tests
For most cases of toe pain, blood work is not needed and is only recommended if a diagnosis of gout, psoriatic arthritis, or an infection is suspected.
Blood tests can be used to test for levels of uric acid in your blood, which are often found to be elevated in people with gout. Blood tests can also be used to measure levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)—two inflammatory markers that are often elevated in autoimmune conditions like psoriatic arthritis.
A complete blood count (CBC) that measures the cells of your immune system might be ordered to help your provider determine if you have an infection or autoimmunecondition.
Imaging
Imaging methods can be used to look at the structures in and around your toe joint and check for damage. X-rays are typically done first to check for signs of arthritis or broken bones. If an injury to a tendon or ligament is suspected, you may need to have an MRI to check for a sprain or tear.
Joint Aspiration
If a joint infection or condition like gout is suspected based on your pain, redness, and swelling in one of your toes, your healthcare provider may perform a joint aspiration to remove fluid from your toe joint. This fluid is then tested to check for abnormalities.
Treatment
Treatment options for toe pain vary depending on the cause and severity of your symptoms. Many causes of toe pain can be managed conservatively with medication and at-home treatments, but surgery might be needed for serious or chronic injuries.
Lifestyle Treatment Options
Simple at-home methods can be used to help manage toe pain, including:
- Ice or heat for pain relief
- Topical pain relieving creams or gels
- Gentle stretching of your toes
- Resting from prolonged standing and walking
- Wearing supportive, properly-fitting footwear
- Bandages or cushions to decrease friction and pressure
- Splinting or immobilizing your toes for support to allow them to heal
- Making dietary changes, like cutting out shellfish and alcohol, if you have gout
Medications
If needed, medication can be used to help reduce your pain levels. Over-the-counter (OTC) pain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or stronger prescription-strength opioids can be taken by mouth. You may need medicine delivered through a steroid injection in your toe joint.
If you have a systemic condition causing your toe pain, your healthcare provider may prescribe medication to decrease inflammation throughout your body. For example, colchicine or allopurinol to treat gout, antibiotics to treat an infection, and disease-modifying anti-rheumatic drugs (DMARDs) or biologics to treat autoimmune conditions like psoriatic arthritis.
Surgery
For significant injuries or deformities of your toes that cause ongoing pain and limit your ability to comfortably stand and walk, surgery might be considered to improve the alignment of your toe joints.
Surgery is only considered after trying other treatment methods for several weeks or months. The exception is if you have a severe toe fracture, in which case surgery might be performed as soon as possible.
Causes of toe pain where surgery that might require surgery include:
- Toe fractures
- Bunions
- Severe cases of turf toe
- Severe osteoarthritis of the big toe
- Claw and hammer toe deformities
- Sesamoiditis
Prevention
The most important factor when it comes to preventing toe pain is wearing supportive, properly fitting footwear. Many toe injuries and conditions result from increased friction and compression from shoes that are too rigid or too tight.
Supportive shoes that have arch support, a sturdy sole, cushioned insole, and an adequately sized toe box to prevent squishing your toes together can help prevent irritation to the skin, nails, and joints of your toes.
Summary
Toe pain can result from a variety of causes, including osteoarthritis, gout, turf toe, bunions, ingrown toenails, fractures, sesamoiditis, dactylitis, claw and hammer toes, peripheral neuropathy, and corns, calluses, and blisters.
While most causes of toe pain can be addressed with at-home treatments and medication, some severe or ongoing causes of toe pain may require surgery to correct the alignment of your toe joint to relieve your pain.
Wearing supportive and properly fitting footwear is key for both preventing and treating many causes of toe pain.
A Word From Verywell
Movement on your toes, especially your big toe, is crucial for allowing you to walk properly as you go about your daily activities. While many causes of toe pain can be treated and managed at home, see your healthcare provider if you have been experiencing pain for longer than one week.
Unaddressed causes of toe pain can significantly impact your ability to walk and maintain your balance. It's best to treat them early to prevent conditions from causing permanent damage.