10 Reasons Why You Might Have Toe Pain
Toe pain can result from an injury, an underlying disease, or an ill-fitting pair of shoes. Here are some common causes, symptoms, and treatments for toe pain.
Understanding toe pain
If you’ve ever stubbed your toe walking to the bathroom in the dark then you understand that for something so tiny, a toe can cause real agony. Your toes may be small but they play an important role in your body, making up one-third of your foot stability.
“Think of your foot like a three-legged stool, supported by your heel, big toe/ball of your foot, and the remaining toes,” says Kenneth Jung, MD, orthopedic foot and ankle surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.
“A problem in any one of these will affect the others and your foot as a whole.”
Head, shoulders, knees, and toes (and feet)
Your toes are composed of bone, muscle, tendon, nerves, and arteries and pain can result from illness or injury in any of these, says Sophia Solomon, DPM, board-certified podiatrist and foot surgeon in Manhattan.
Problems that start small can cascade into larger issues that affect more tissues and can even cause lasting deformities that require surgery or other invasive treatments.
Left untreated, foot and toe pain can impair your mobility, inhibiting your ability to exercise, work, do your hobbies, and live your life. Toe problems can also become a source of chronic pain, leading to life-altering problems like insomnia and depression.
“Once you have foot or toe pain, the earlier you treat it, the better off you will be,” says Dr. Solomon. “This can become debilitating, this isn’t something you want to ignore.”
(Got pain on top of your foot? Here’s how to treat it.)
Risk factors for toe pain
Toe and foot pain can happen to anyone anytime—as anyone who has stepped on a Lego can attest—but there are things that increase your risk, says Dr. Jung. Knowing your personal risk factors can help you prevent and mitigate pain, illness, and injury.
A lot of your propensity for certain types of toe pain can be traced to your parents. Your genes not only dictate your toe shape and size but can also determine things that indirectly cause toe pain, like flat feet or a higher risk for inflammatory arthritis.
Your individual anatomy
Each person’s feet are unique. Even slight differences in the angles of your joints, the laxness of your tendons, the tightness of your skin, the placement of your nerves, and the structures of your bones can change your risk for toe pain, says Dr. Jung.
The world you live in can take a serious toll on your feet. Working jobs that require you to be on your feet for long periods of time or playing a sport that requires impact to your feet, like soccer, can increase your chances of having foot and toe pain, says Dr. Jung.
(Here’s why you may have pain in the ball of your foot.)
Your overall health, including exercise and nutrition habits, can also play a role, says Dr. Jung.
Being overweight or obese can cause foot problems. Certain diets, like those high in inflammatory foods or a chemical called purine, can exacerbate toe problems brought on by arthritis, like gout. High-purine foods include organ meats (liver), red meat, alcohol, and sugar-sweetened foods.
Uric acid is formed when the body breaks down purine. With gout, high levels of uric acid in the blood can cause crystals to form around a joint.
Other lifestyle factors, like your choice of shoes (more on that below), your hobbies (like running), and the type of flooring in your home can also play a part in toe pain.
Wearing high heels or pointy-toed shoes can also increase the risk.
It’s a sad fact of aging but as you get older, your feet—along with the rest of the bones and joints in your body—become more prone to overuse, illness, and injury, says Dr. Solomon.
Women are more prone to certain types of foot pain. This is partly due to biological effects, like hormones. For instance, the hormone relaxin relaxes the joints and decreasing levels of estrogen during menopause can lower bone density, both of which can increase toe pain.
Women also may be more prone to some types of inflammatory arthritis, although men are at greater risk of gout, a type of arthritis. Gout is known to cause severe toe pain, and often pain and swelling in a big toe is one of the first symptoms.
Men are also at greater risk than women of type 2 diabetes, which can affect the feet. Men with type 2 diabetes tend to have an earlier onset of diabetic neuropathy, which is nerve damage that can cause numbness, tingling, and pain in the feet.
(These are the ways podiatrists say you’re killing your feet.)
Many diseases, including arthritis, diabetes, multiple sclerosis, and osteoporosis may have toe pain as a symptom or can increase your risk of foot and toe pain.
Swollen, red toes can also be a sign of Covid-19.
Common causes of toe pain
Before you treat your toe or foot pain, you need to get an idea of what might be causing it. Treating the pain without addressing the underlying concern won’t help and may cause more harm in the long run, says Dr. Jung.
(Here’s everything you need to know about chronic pain, regardless of the source.)
Here are the most common causes of pain or dysfunction in the toes:
A bunion looks like a painful bump at the base joint of your big toe. What you’re seeing is not a growth, however, but bone bending out and sideways over time, says Dr. Jung.
Some bunions may be painless but annoying as they can make fitting shoes more difficult. Others can range from moderate pain to severe disability, where any pressure on the big toe is agonizing.
Many people with bunions have a genetic predisposition for them but doing things that put a lot of pressure on your big toe joint—like wearing high heels for long periods of time—can make them worse. (Here’s how to treat the different types of bunions.)
A bunion is only found on your big toe. Bunionettes are similar bone deformities that occur on other toes, generally your last or pinky toe. (Try these seven ways to treat bunion and bunionette pain.)
This is a physical deformity of the toes, generally your three middle toes, where they curl downward at the middle joint.
Hammertoes are caused by a soft-tissue imbalance where the tissue becomes too tight on the bottom and stretched out on the top, says Dr. Jung. Genetics and wearing too-tight shoes are common culprits.
Plantar warts, corns, and calluses
Any benign growth can cause mild to severe foot and toe pain, says Dr. Solomon. Plantar warts, calluses, and corns are the most common.
It may feel annoying, like walking with a pebble in your shoe, or it can be so painful that the growth must be removed by a doctor.
Plantar warts are caused by a virus, corns are caused by prolonged pressure, and calluses are from rubbing or chafing.
Muscular imbalances in the feet, ankles, and/or legs
Weak leg and foot muscles, combined with bad posture and anatomy problems, can impair the way you walk, leading to pain and structural problems over time, says Dr. Jung.
Pronation and supination—where your feet roll too far inward or outward, respectively—are common manifestations of these imbalances and can cause toe pain.
Because it affects the joints, all types of arthritis—including osteoarthritis, inflammatory (like rheumatoid and psoriatic), and gout—can cause pain, swelling, and deformity in your toes, says Dr. Solomon.
While these conditions can be painful on their own, they also increase your risk of toe pain by changing the way you walk and making it harder to find shoes that fit properly, she adds.
Arthritis is most common in your big toe because that’s the joint that does most of the work.
Poorly fitted shoes
Cramming your feet into too-small shoes can lead to a host of foot and especially toe problems, says Dr. Solomon. A narrow toe box can cause painful ingrown toenails and worsen bunions while narrow shoes can change the way you walk leading to foot and ankle instability and pain.
High heels can cause or worsen bunions and hammertoes.
(These are the common shoe mistakes you may be making.)
The nerves going to your toes can become scarred or thickened over time, particularly if they are injured or are impacted in the same spot repeatedly.
For instance, wearing tight soccer cleats while repeatedly kicking the ball with the same spot on your inner foot. This leads to pain, burning, and numbness at the focal spot where the nerve is compressed, says Dr. Jung.
Bony growths can occur on your toes, as a result of injury, genetics, or for no reason at all. These may be painless but often as they get larger they can cause a lot of toe pain.
The small bones in your toes and feet are relatively fragile and they have to handle a lot of impact every day, making them more prone to both stress fractures and regular fractures, Dr. Solomon says.
These can be hard to spot and many people will go for days or weeks without even realizing they broke a foot bone, she says.
How to treat toe pain
Treatments for toe pain vary based on the severity and cause, says Dr. Solomon.
This is why it’s essential to get evaluated by a medical professional if you have pain, redness, swelling, and/or stiffness in your toes that lasts longer than two weeks. What you may think is the cause may not be the true underlying issue.
For instance, it’s not uncommon for patients to come in with what they think is an injury from stubbing their toe only to discover they actually have gout or a bunion. (Make sure you’re not doing these things that put your feet at risk.)
Mild toe pain can be treated at home and it’s worth trying some of these things to see if they provide relief, says Dr. Jung. These can include
- taking over-the-counter anti-inflammatory medications, like ibuprofen
- using warm or cool compresses
- wearing a toe splint
- eliminating certain foods from your diet like those high in purine
- using toe separators
- changing activities
- taking a break from activities that cause pain
- always wearing cushioned shoes rather than going barefoot at home
(These are the hidden dangers of OTC medicine.)
Underlying anatomical issues or injuries to your bones, joints, or nerves needs to be addressed by a podiatrist or orthopedist, says Dr. Jung.
Depending on the cause of your toe pain, your doctor may recommend medications, in-office procedures and/or surgery. Bothersome warts and corns may be removed with local anesthesia and broken bones may need to be taped or splinted.
Some causes of toe pain, like bunions, can only be completely resolved with surgery.
(Psst, here are the secrets your surgeon won’t tell you.)
Treat underlying diseases
If your toe pain is caused by an illness, like arthritis or diabetes, you need to work on getting the disease under control first, says Dr. Solomon. You can use home remedies and medications in the meantime to manage symptoms, but for real relief, you must address the underlying illness.
(These are the silent signs you may have health problems.)
Some toe pain, like that caused by hammertoes or muscular imbalances, can benefit from targeted foot stretches and exercises. These can also help pain from other sources, like bunions, from progressing further, says Dr. Jung.
Talk to a certified physical therapist about which stretches and exercises will most benefit you. (These are the secrets physical therapists know about you.)
Custom orthotics—insoles designed to address an individual’s foot issues—can help reduce toe pain caused by anatomical and gait problems. However, these can be very expensive and the research is mixed on whether or not they provide long-term relief.
It’s also worth trying more affordable drugstore varieties to see if they provide some pain relief, says Dr. Jung.
(Here are the best walking shoes for your feet.)
The last word
There are many different causes of toe pain, from an injury to underlying health conditions. In many cases, toe pain can usually be treated with home remedies, but, remember to refrain from any activities that may exacerbate the pain.
If your toe pain comes suddenly, see your doctor for a diagnosis and to determine the best course of treatment for you.
Next, these are the foot-health secrets you should know.
- Sophia Solomon, DPM, board-certified podiatrist and foot surgeon in Manhattan and researcher with Hospital of Special Surgery an academic orthopedic medical center
- Kenneth Jung, MD, orthopedic foot and ankle surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles
- Journal of Diabetes Complications: Gender differences in the onset of diabetic neuropathy
- Current Rheumatology Reports: Racial and gender disparities among people with gout