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What Causes Big Toe Pain?

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Last updated January 3, 2024

Big toe pain quiz

Take a quiz to find out what's causing your pain.

Experiencing big toe pain can also cause pain when walking, swelling in the toe, or discoloration of the big toe. Common causes of pain in the big toe are a broken or sprained big toe, nerve damage, or gout. Read below for information on more causes and big toe joint pain treatments.

Big toe pain quiz

Take a quiz to find out what's causing your pain.

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The sharp, shooting pain in your big toe symptoms explained

While small in comparison to the rest of the body, the big toe is often stubbed, twisted, bumped, or otherwise injured. You know the big toe well: it is typically the largest toe on the innermost side of your foot. Your toes touch the ground for much of your day, which makes them crucial to movement and balance. So, when your big toe hurts, you notice. The entire foot consists of bones, ligaments, tendons, and muscles with more than half of those bones located in the toes. Any issues among these components can result in pain that may or may not respond to treatment at home.

Common characteristics of big toe pain

If you're experiencing big toe pain it will likely present with:

  • Discomfort while walking
  • Tenderness
  • Swelling
  • Bruising or discoloration
  • Misalignment
  • Bumps or other disfigurement: Corns, bunions, ingrown toenails, etc.

What causes pain in the big toe or big toe joint?

Trying to identify the cause of your big toe pain can help you decide if and when to see a physician. The following details may help you better understand your symptoms.

Environmental causes

Environmental causes may include the following.

  • Trauma: Bruising, spraining, dislocation or fracture can occur when the toe is struck by an object or stubbed.
  • Nerve damage: Subtle sources of pain may also occur from athletic activities or be the result of ill-fitting shoes. These actions can compress nerves through repetitive actions or one-time events.
  • Surface damage: Frequent friction and pressure on the toes can result in damage to the surface of the toes. Corns and calluses are examples.

Inflammatory causes

Diseases that cause the body to attack itself result in a variety of painful symptoms, particularly in the joints. Arthritis and gout are examples of such autoimmune diseases.

This list does not constitute medical advice and may not accurately represent what you have.

Toe fracture

Broken toes are very common and caused by either something falling on the toe (crush injury) or a stubbing of the toe situation.

You should see your primary care doctor or an urgent care in the next day. X-rays would be taken to determine if it's a fracture or a bad bruise (toe contusion). Treatment is simple, just putting the toe in the right place and taping it to its healthy neighbor toe.

Rarity: Common

Top Symptoms: constant foot pain, toe injury, toe pain from an injury

Symptoms that always occur with toe fracture: toe injury, toe pain from an injury, constant foot pain

Symptoms that never occur with toe fracture: toe dislocation, toe injury with broken skin

Urgency: Primary care doctor

Toe bruise

Toe contusion (bruise) is the damage of the blood vessels (veins and capillaries) that return blood from your tissues back to the heart. The blood pools there and turns blue or purple. It's typically caused by a bump, hit, or fall.

You can safely treat this at home with rest (no exercise), ice (10-20 minutes at a time), compression (via tape or a wrap), and elevation (putting your feet up. Over-the-counter pain medications can also be used if the pain is really bothering you.

Rarity: Rare

Top Symptoms: constant foot pain, toe injury, toe pain from an injury, swollen toes, toe bruise(s)

Symptoms that always occur with toe bruise: toe pain from an injury, toe injury, constant foot pain

Urgency: Self-treatment

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Raynaud phenomenon

Raynaud phenomenon, also called Secondary Raynaud syndrome, is a condition that causes small arteries in the skin to abnormally constrict on exposure to cold water or air. This limits blood flow to the hands, fingers, feet, toes, nose, and ears.

Secondary Raynaud syndrome is rare and is caused by another underlying medical condition, often a connective tissue disorder such as rheumatoid arthritis, scleroderma, or lupus.

Women are more likely than men to be affected, especially if living in cold climates. Family history and smoking are also risk factors.

Symptoms include the hands and feet becoming numb and cold. The skin color changes from pale to bluish, and then to red as the skin warms again.

If not treated, patients may get ulcerated sores or deformities of the fingers and toes, or even gangrene, due to the lack of circulation.

Diagnosis is made through patient history, physical examination, and blood tests.

Treatment includes medications to help increase circulation; treatment of any underlying conditions; and lifestyle changes to gain better protection for the extremities in cold conditions.

Rarity: Common

Top Symptoms: distal numbness, cold toe, cold fingers, spontaneous toe pain, spontaneous finger pain

Urgency: Self-treatment

Nail infection (paronychia)

Paronychia is an infection of the skin of the fingers or toes, at the place where the skin folds down to meet the nail.

Acute, or sudden onset, paronychia is caused by the staphylococcus bacteria. The organism can gain entry if the nail is cracked, broken, bitten, or trimmed too closely.

Chronic, or ongoing, paronychia is caused by a fungus. Anyone whose work requires their hands to be wet much of the time is susceptible.

People with diabetes or a weakened immune system are more susceptible to nail infections.

Symptoms include sore, reddened, swollen skin around the nail, sometimes with pus collecting under the skin.

Diagnosis is made through physical examination and sometimes skin culture to identify the organism involved.

Treatment for acute paronychia involves having a medical provider clean the wounded nail and drain any infection, and sometimes provide a course of antibiotics.

Treatment for the chronic form involves keeping the skin dry and using an antifungal medication on the affected nail.

Rarity: Rare

Top Symptoms: spontaneous finger pain, fingernail pain, fingernail swelling

Urgency: Phone call or in-person visit

Morton neuroma

Morton neuroma, also called by the older name Morton's neuroma, is a thickening of fibrous tissue in the ball of the foot. This tissue encapsulates the nerve leading to the third and fourth toes.

It is not actually a tumor of the nerve, as the name suggests. The thickening is caused by years of trauma, irritation, and/or compression to the feet. High-heeled shoes, especially if narrow or tight, are a common cause. The condition is most often seen in women over age 45.

Symptoms include burning pain in the ball of the foot, especially with walking or running. The condition will not heal on its own and can lead to chronic foot pain.

Diagnosis is made through physical examination of the foot with simple range of motion exercises, and sometimes x-ray.

Treatment includes changing to better-fitting shoes that do not compress the nerve; using orthotics in the shoes to take more pressure off of the nerve; and in some cases the use of corticosteroid injections.

Rarity: Rare

Top Symptoms: foot numbness, pain in the sole of the foot, pain when touching the foot, pain in both feet, foot injury

Urgency: Self-treatment

Gout

Gout is a form of arthritis that causes sudden pain, stiffness, and swelling in a joint. The big toe is often affected, but it can also happen in other joints. Sometimes, the joint gets hot and red. Gout is caused by uric acid crystals. Risk factors for gout include obesity, eating a lot of meat, drinking beer, age (older), sex (male), and family history.

You should see a healthcare professional to see if uric acid crystals have accumulated in the joint. Gout can be diagnosed based on symptoms, but it's also common to take a sample of joint fluid for testing. A physician can give you a prescription for anti-inflammatory medications and/ or pain medications. There are also medications to stop your body from making too much uric acid. Sometimes, a shot in the joint can help with symptoms also.

Rarity: Common

Top Symptoms: swollen toes

Urgency: Primary care doctor

Bunion

A bunion is a deformity of the joint at the base of the big toe. Certain footwear styles can worsen s.

You should visit your primary care doctor, who can help you pick out good footwear. Surgery is considered if footwear change does not control pain symptoms.

Rarity: Common

Top Symptoms: bump on outside edge of big toe, big toe pain, toe pain that gets worse when wearing closed-toe shoes, foot ulcer, pain at the base of the toe

Symptoms that always occur with bunion: bump on outside edge of big toe

Urgency: Primary care doctor

Treatment for sharp, throbbing, or shooting pain in the big toe

Home remedies, like rest, often soothe big toe pain symptoms. However, the underlying cause of big toe pain can be more severe and, if left untreated, can result in long-term issues.

At-home treatments

Try the following treatments at home to address your big toe pain symptoms.

  • Rest, ice, and elevation: Try to stay off your feet — this advice may frustrate you, or you may look forward to relaxation. Apply ice for approximately 15–20 minutes at a time throughout the day to reduce swelling.
  • Soak: Soak your toe in warm water for 3–5 minutes several times for corns and calluses. Doing so will allow the tissue to soften and come off with a pumice stone.
  • Pain medication: Non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen (Advil, Motrin) or corticosteroid injections can also help reduce pain.
  • Proper footwear: Tight or ill-fitting shoes can damage the toes. Shoes should be wide enough for all toes to fit comfortably.

When to see a doctor

See a doctor if you experience any of the following symptoms.

  • Severe pain
  • Persistent pain that does not subside for over a week: Or you also have diabetes
  • Signs of infection
  • Swelling that will not subside for several days
  • Pain that prevents walking

Medical treatments

After consulting your physician, he or she may recommend the following.

  • Surgery: Surgical procedures can remove bunions, repair ingrown toenails, realign joints, or repair broken toes.
  • Injections: The injection of anti-inflammatory medications, particularly at joints, can help with the pain. Corticosteroid injections are an example of this application for the big toe.
  • Medications: Gout requires medication that soothes pain and inflammation.

FAQs about big toe pain

Why does my big toe feel numb?

Big toe numbness can occur for a variety of reasons. Overly tight footwear is a common cause. Tight shoes compress nerves in the toe, causing numbness. Numbness and pain in the big toe indicate gout. Infections from ingrown toenails may also lead to numbness.

Why does my big toe randomly hurt?

Big toe pain is often due to strain on the toe from athletics or improper footwear. Either of these causes may result in the toe hurting only after specific incidents. Gout also causes big toe pain in distinct episodes; pain will not be constant.

Does gout cause big toe pain?

Gout causes pain and swelling in joints and targets the big toe. A type of arthritis, gout is caused by the buildup of uric acid in joints. The condition frequently affects the big toe first before impacting additional parts of the body.

How do you know if you broke your toe or sprained it?

A broken big toe will appear crooked, bruised, and swollen. The break may also cause an open wound on the toe. A sprained big toe will most likely retain its form. The toe will exhibit swelling and bruising, but the symptoms will be less severe than if the toe is broken.

What does an ingrown toenail feel like?

An ingrown toenail most commonly affects the big toe, resulting in pain to the touch and redness. Pain is the worst when the toe is bumped, but the slightest touch can sometimes cause discomfort. Wearing shoes may be a challenge. Ingrown toenails can result in infections that cause pus to drain from the area.

Questions your doctor may ask about big toe pain

  • Did you recently injure your foot?
  • Have you ever been told you have flat feet?
  • How would you explain the cause of your foot pain?
  • Has a bunion formed on your foot?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Hear what 2 others are saying
Once your story receives approval from our editors, it will exist on Buoy as a helpful resource for others who may experience something similar.
The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Pain near first metatarsal may well be goutPosted March 6, 2024 by K.
Gout is a possibility too!
Throbbing redness fluid-filled big fat toePosted March 29, 2021 by D.
Hello, I have a fluid-filled area between nail and joint on my big toe. It started Friday morning. Saturday morning it got bigger. By Sunday I can't even put pressure on it. Monday I can barely get a sock on. It hurts to touch and it's soft fluids inside. I was deciding to pop it till I started reading that it could be infected and spread, which I don't want. I've never had this before in my 52 years, first time. It hurts so bad that last night I couldn't sleep because the throbbing was so intense. I work outdoors in construction, wet cold weather. I have a funny feeling it's not gout as I don't drink alcohol or eat lots of red meat. Now I do remember my little brother, back in the day as kids, dropped a 50-lb vice on my big toe and I never had it looked at. So time has taken its course. I have a funny feeling it is arthritis or really infected with fluid. I almost want to get a needle and push out the fluids. So I will decide to see my family doctor and get better results. Sadly, I'm in a pandemic. It's a hassle to see my family doctor at this time. Hospitals, I'm not going near as spread of virus could be bad for me as my immune system is low right now. So anyone have any suggestions? I'm listening.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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