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Common toe pain causes include bunions & toenail problems. Toe injuries (sprains & fractures) and medical problems (gout & diabetes) can also cause toe pain.
Toe pain symptoms
There are many conditions that cause toe pain including medical illnesses, acute toe injuries, and chronic foot and toe problems leading to pain. There are several possibilities outlined briefly below, as well as further details in the causes section.
Common chronic causes of toe pain include bunions, toe deformities, and toenail problems. Common toe injuries include sprain and fracture. Common medical problems leading to toe pain symptoms include gout, diabetes, and arthritis. Additionally, warts, corns, or calluses can cause toe pain. Some causes of toe pain like mild injuries can be treated at home with rest and ice. Most other causes of toe pain symptoms, including chronic issues, medical illnesses, and serious injuries, require a doctor to diagnose and treat the condition.
Common accompanying symptoms of toe pain
If you are experiencing toe pain, it's likely that you may also experience:
Causes of toe pain
There are many different causes of toe pain. These include chronic toe conditions that cause pain; acute injuries that lead to toe pain; and medical illnesses that can cause toe pain among other symptoms.
Chronic foot or toe conditions
Conditions of the foot can lead to toe pain, such as the following.
- Bunions: A bunion is a malformation of the foot that causes the big toe to point inwards and leads to pain and difficulty walking. The cause of this deformity is unknown, but it increases with age.
- Toe deformity: There are several common toe deformities, including hammertoe, that can cause toe pain symptoms. Typically, these deformities arise from injury, inflammation, or trauma to the foot, although some are genetic. Diabetes and arthritis predispose patients to these types of deformities.
- Nerve problem: Compression of nerves in the foot can lead to toe pain. Typically, the pain associated with nerve compression is described as a burning sensation and is located in between toes.
- Toenail problems: There are multiple possible issues with the toenail that can cause toe pain. Ingrown toenails occur when the toenail pierces the skin around the nail leading to inflammation and possible infection. A hematoma can form under the nail after a trauma and cause pain and discoloration.
Injuries or acute toe conditions
Injuries — especially if they're severe or not given time to heal — can lead to toe pain.
- Fracture: Pain in the toe in the setting of trauma to the forefoot raises concern for a toe fracture. Typically, a fracture would present with acute pain, swelling, and possibly deformity to the area. Stress fractures in the toe may happen over time in the setting of overuse and would also cause pain and swelling to the affected toe.
- Sprain: The most common type of toe sprain occurs with hyperextension of the big toe and is common among soccer or football players.
- Warts: Warts can form on the bottom of the toes or feet, leading to toe pain. Plantar warts are caused by a virus called HPV type 1 or type 2. Calluses or corns are small lesions that form on the bottom of the toes or feet from excess pressure to the bottom of the foot. These can be mistaken for warts but are not caused by a virus.
Other medical conditions can lead to toe pain, such as the following.
- Gout: Gout typically causes intense pain in the large toe joint. Gout is a disease in which crystals deposit in the joint causing inflammation and pain. While gout can cause pain in other joints, the big toe joint is the most common location.
- Rheumatoid arthritis: Rheumatoid arthritis causes pain and stiffness in the joints, particularly common in the finger and toe joints.
- Diabetes: Over time, diabetes affects the nerves in the feet, which can lead to pain, burning, or numbness in the toes and feet. Because the toes may be numb, patients with diabetes are at higher risk of developing ulcers or sores on their feet or toes that go unnoticed. These have the potential to become infected and can be limb-threatening.
This list does not constitute medical advice and may not accurately represent what you have.
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.
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
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.
Top Symptoms: foot numbness, pain in the sole of the foot, pain when touching the foot, pain in both feet, foot injury
Gout is a form of arthritis that causes sudden pain, stiffness, and swelling in a joint. The big toe is often affected.
Top Symptoms: swollen toes
Urgency: Primary care doctor
Broken toes are very common and caused by either something falling on the toe (crush injury) or a stubbing of the toe situation.
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
Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness throughout the body. Rheumatoid arthritis (RA) is a chronic condition that is autoimmune in nature, meaning that the body's immune system which normally protects the body by att...
Psoriatic arthritis is a condition which causes inflammation of the joints. In most circumstances, psoriatic arthritis presents between the ages of 30 and 50 years and occurs after the manifestation of the symptoms of psoriasis, which is a disease of the skin. Psoriatic arthritis...
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.
Top Symptoms: distal numbness, cold toe, cold fingers, spontaneous toe pain, spontaneous finger pain
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.
Top Symptoms: spontaneous finger pain, fingernail pain, fingernail swelling
Urgency: Phone call or in-person visit
Toe pain treatments and relief
Some causes of toe pain can be treated at home. Minor injuries such as sprains can be treated with rest and ice, as well as over-the-counter pain medications.
Treatment for mild to moderate toe pain can begin at home, such as the following.
- Over-the-counter pain medication: If your toe pain is due to an acute or chronic injury, an over-the-counter NSAID pain medication such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may help relieve the symptoms.
- Rest: If your toe pain is related to sports or exercise, taking a break from the activity that causes pain may help with recovery.
- Ice: If your toe pain is related to inflammation or minor injury such as a sprain, placing ice on the area may help to alleviate pain.
When to see a doctor
For other chronic causes of toe pain, a visit to the doctor may be helpful in diagnosing and treating the pain. If you suspect a medical illness is the cause of your toe pain, your doctor will diagnose and treat the toe pain symptoms. He or she may recommend the following.
- Steroid injection: In some cases of toe pain, an injection of steroids may reduce inflammation and help the pain. Your doctor can help determine if this is the appropriate treatment for your toe pain symptoms.
- Medications: If your toe pain is due to gout, diabetes, or arthritis, your doctor may prescribe medication to control your illness that will help control the symptom of toe pain. If your doctor suspects an infection in your toe or foot, they may prescribe antibiotics.
- Orthotics or special shoes: If your doctor suspects your toe pain is due to bunions or another deformity, they may suggest orthotic shoe inserts or even special shoes to help with the toe pain symptoms.
- Wart removal: If your toe pain is due to warts, your doctor may suggest wart removal. There are multiple different types of removal, and your doctor can help you figure out the best one for your condition.
- Surgery: If you doctor determines a bunion or other structural issue is the cause of your toe pain, they may recommend surgical correction. A podiatrist or orthopedic surgeon can help determine if surgery is the appropriate treatment for your toe pain.
When it is an emergency
For more serious injuries, seek medical attention right away. This includes:
- Suspected fracture
- You have severe pain or swelling of the toe
- You are bleeding severely
- You are having severe difficulty walking
- You have a wound or lesion that is not healing
- You have a fever or other sign of infection
If you have diabetes and also have an ulcer or wound on your foot, seek treatment promptly. Diabetic foot ulcers can become infected and lead to loss of a limb.
FAQs about toe pain
Why does my toe hurt at night?
Morton's neuroma and diabetic neuropathy can both cause pain in the toes and feet that is worse at night. Morton's neuroma is caused by overly tight shoes and overpronation of the foot. It can occur between the first and third interdigital spaces or the second and fourth interdigital spaces and radiate toward the toes. Diabetic neuropathy is caused by long-standing diabetes and can cause loss of pain or vibratory sense in the toes, leading to ulcer formation.
Why do my toes curl up?
Claw toes are a type of toe contracture in which the metatarsophalangeal joint faces upward. They are more common in women and more common in individuals in their 7th decade (60s). Younger patients have a higher chance of having a secondary cause of claw toes. This includes disorders like inflammatory arthropathies (rheumatoid arthritis or RA), diabetic neuropathy, or a neuromuscular condition.
What causes pain in the toes while walking?
Many things can cause pain in the toes while walking, including a deviation of the joint or damage to a joint from stress over a long time; an infection or inflammation because of an overactive immune system; a tightening of some of the connective tissue that fixes a toe in a particular position; or trauma to a bone or toenail. A common cause of pain while walking is metatarsalgia, which happens when the structure of the foot is changing and the foot becomes less able to support changes. It is often described as feeling as if one is stepping on a stone. Appropriate diagnosis of foot pain requires diagnosis by a general practitioner or a podiatrist.
Can ingrown toenails cause toe pain?
Yes. An ingrown toenail is caused when a nail plate punctures part of the nail fold and causes inflammation. They can also cause infection. Usually an ingrown toenail is slightly red, swollen, and tender to touch or pressure. Mild cases can be soaked or pulled out of the tissue with sterile items, but anything more severe may require a quick medical procedure done in a physician's or a podiatrist's office.
Why can't I feel my toes?
You may not be able to feel your toes for a variety of reasons. The most common reason for loss of sensation is cold temperature. Cold temperature causes a constriction of the blood vessels that carry blood to the toes and tends to slow down nerve impulses to a particular part of the body, including but not limited to the toes. Other causes of sudden loss of toe sensation may need immediate evaluation.
Questions your doctor may ask about 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.
Dr. Martin is an Emergency Medicine resident at the University of Washington in Seattle. She received her undergraduate degree from Stanford University where she majored in Human Biology, and received her MD from the University of Pennsylvania. She’s interested in Emergency Medical Services and Flight Medicine, and is currently a resident flight physician with Airlift Northwest. In her free time, she enjoys playing ultimate frisbee, cycling, rock climbing, and trail running!
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