by Last updated on March 11th, 2024 at 12:15 am
The toe pain causes discussed in this article are not exhaustive. However, it highlights some of the leading causes of toe pain. Use it as a guide, and remember to see a healthcare provider if you doubt what is causing your toe pain. Read on!
Ingrown toenail
An ingrown toenail is a common foot problem that occurs when the edges of a toenail grow into the skin of the toe at the corners or sulcus. Ingrown toenails are often caused by wearing shoes that are too tight or by trimming the toenails incorrectly. An involuted nail (curved nail) and trauma are also risk factors. The big toe is most commonly affected but can also occur on the other toes. Symptoms of an ingrown toenail include pain, redness, swelling, and tenderness in the affected area. In some cases, the skin may also become infected. If left untreated, an ingrown toenail can lead to more serious complications, such as cellulitis, sepsis or osteomyelitis.
Safe care for an ingrown toenail typically involves soaking the affected foot in warm boiled salt water to clean the wound and applying a clean dressing. If the ingrown toenail is severe or becomes infected, a healthcare provider may prescribe antibiotics to treat the infection. Sometimes, they may need to remove part or all of the affected nail (partial or total nail avulsion). Wearing appropriately fitted shoes, and trimming nails correctly, will help prevent ingrown toenails from occurring.
Big toe bunion
A bunion is a bony protrusion that forms on the joint at the medial side of the big toe. It is caused by the misalignment of the bones, resulting in the big toe pointing towards the other toes. There is no consensus on the cause, but researchers believe that bunions can be inherited or caused by wearing shoes which are too narrow or have high heels. Conditions like rheumatoid arthritis and hypermobility syndrome are also risk factors.
Symptoms of a bunion include pain on top of the big toe as well as the inside, swelling, and difficulty walking. The skin over the bunion may also be red and tender. Bunions can cause additional problems, such as osteoarthritis, corns, calluses and ingrown toenails. Treatment for a bunion typically involves wearing shoes with a wider toe box, reduced heels and using pads or inserts to help alleviate pressure on the bunion. In severe cases, surgery may be necessary to correct the misalignment of the bones to reduce pain. Typically, bunion surgery is not done for aesthetic purposes.
Little toe bunion
A little toe bunion is sometimes referred to as a Tailor’s bunion or bunionette. Constant pressure on the outside of the toe can lead to the development of a bunion and cause pinky toe pain. Sometimes the bones that make up the little toe joint deviate, and the pressure and persistent rubbing cause a bone spur to develop. Symptoms include redness, swelling, tenderness and throbbing. Treatment includes icing, a toe brace, foam or gel padding, wider shoes and, in some cases, an orthotic. If the pain is persistent, see a podiatrist or another healthcare provider. They will help you with a treatment plan.
Verrucas
Verrucae, also known as plantar warts, are a common viral infection of the skin that can cause painful growths on the toes. The highly contagious human papillomavirus (HPV) is the cause. It is transmitted through direct contact with an infected person or contact with surfaces such as gym floors or public showers. Verrucae can be painful, especially when located on a weight-bearing area such as the toes, ball of the foot or heel.
They are unsightly and often make people embarrassed or self-conscious. Treatment options for verrucae include over-the-counter topical or prescription topical medications, cryotherapy (freezing the wart), needling, microwave or surgery to remove the wart. Zinc supplementation, as an adjunct, is reported to have some benefits. Also, a weak immune system is a risk factor. It is essential to keep affected areas clean and dry to prevent the spread of the virus to other parts of the body or others. It is also important to practice good hygiene by washing your hands frequently and wearing flip-flops or sandals in public showers to prevent the spread of the virus.
lesser toe deformity
A lesser toe deformity includes hammer, claw and mallet toes. A hammer toe is a deformity that occurs in the middle joint of a toe, causing it to bend downward and resemble a hammer. It often cause middle toe pain. A claw toe occurs when both joints are bent, resembling a claw, and a mallet toe is when the distal joint is bent, resembling a mallet. Although not always pathological, these conditions can be painful and make walking or wearing certain shoes difficult. The most common cause of lesser toe deformity is wearing shoes that do not fit properly, such as shoes with a narrow toe box or high heels. Genetics, nerve damage, and medical conditions such as arthritis and diabetes are also risk factors.
Symptoms of a pathological lesser toe deformity include a bent toe, pain when walking or wearing certain shoes, and the inability to straighten the toe. Hard skin on toe such as corns and calluses may also develop at pressure points. Treatment options include wearing shoes with a deep toe box, using toe pads to alleviate pressure, and performing stretching and strengthening exercises. Lesser toe deformity can worsen over time, and surgery may be necessary to correct the deformity in severe cases.
Osteoarthritis
Osteoarthritis is a degenerative joint disorder that can cause pain and stiffness in any of the toes, but it most often affects the big toe. Wear and tear of the joint is the leading cause. The condition is characterized by a bony growth, or spur, on the top of the joint, which may limit the range of motion in the toe. In the big toe, the condition is sometimes referred to as hallux limitus or rigidus. In advanced hallux rigidus, the toe may become rigid and unable to bend.
Osteoarthritis is more common in older individuals but can also occur in younger people who have suffered an injury to the toe or have a genetic predisposition to developing osteoarthritis. Treatment options for osteoarthritis of the toe include medications, footwear with a thick sole and a rocker bottom to help relieve pressure, physiotherapy, and in some cases, surgery to remove the spur or fuse the joint permanently to reduce pain.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that causes inflammation in the joints, resulting in damage, pain, swelling, and stiffness. In other words, the body is attacking its healthy cells and often can lead to swollen painful toes with no injury. It can affect any joint in the body, including the toes. When RA affects the toes, it can cause lesser toe deformities, such as hammer, claw or mallet toes. It can also lead to difficulty walking or standing due to pain and discomfort.
RA can also cause fatigue, overall weakness, and a loss of function in the affected joints. In severe cases, RA in the toes may lead to joint destruction, which can require surgical intervention. RA is typically treated with a combination of medications and lifestyle modifications. It is critical for individuals with RA to closely monitor their condition and seek prompt medical treatment to prevent further joint damage.
Gout
Gout is a type of arthritis that occurs when uric acid builds up in the body and forms crystal deposits in the joints, leading to inflammation and pain. The big toe is a common site for gout, the reason for this is still unclear, but it may have to do with repetitive force and trauma to the big toe. Gout can attack suddenly, causing sharp stabbing pain in the big toe, often waking you up at night. The affected toe may become red, swollen, and tender to the touch.
Walking and wearing shoes can be difficult due to swelling and pain. Left untreated, sometimes it goes away, but if recurrent, it can cause tophi formation – lumps under the skin filled with uric acid crystals which can damage the joint. Lifestyle changes, such as a low-purine diet, weight loss, and medication, are required to manage the condition.
Sesamoiditis
Sesamoiditis is a condition that affects the tiny bones, called sesamoids, at the base of the big toe joint. These bones help to give mechanical advantage to the flexor hallucis tendon during gait. Sesamoiditis is inflammation of these bones and the surrounding tendons and tissue, which repetitive stress, high-impact activities, or improper footwear can cause. Symptoms of sesamoiditis include pain, tenderness, swelling and difficulty moving the big toe. Treatment for sesamoiditis may consist of rest, ice, anti-inflammatory medication, taping, or an orthotic to relieve pressure. Sometimes surgery is necessary to remove the damaged sesamoids.
Turf toe
Turf toe is a common injury that occurs when the big toe is bent upwards excessively, spraining the joint. The sesamoids, flexor hallucis brevis tendon and plantar plate often get injured. Athletes, particularly those who play on artificial turf, hence the name “turf toe”, are susceptible. The mechanism of injury involves hyperextension of the great toe. Symptoms of turf toe include pain and swelling at the base of the big toe, difficulty walking, and decreased range of motion in the affected joint.
The injury can range from mild to severe, with more severe cases requiring rest, ice, elevation, anti-inflammatory, medications and possibly surgical intervention. It is essential to wear proper footwear with good support and to warm up and stretch before physical activity. If you do experience turf toe, seek medical attention.
Psoriatic arthritis
Psoriatic arthritis is a type of inflammatory arthritis that occurs in people with psoriasis, a chronic skin condition characterized by red, scaly patches on the skin. It is an autoimmune disease, meaning the body’s immune system mistakenly attacks healthy tissue. In people with psoriatic arthritis, the immune system attacks the joints, leading to inflammation and pain. One common location for this inflammation is in the toes, which can cause pain, dactylitis or sausage toe (swelling), stiffness, and difficulty moving the toes.
If left untreated, psoriatic arthritis can damage the joints. Treatment options include medications to reduce inflammation and suppress the immune system to stop it from attacking healthy cells, appropriate footwear and physiotherapy. Some people have tried complementary therapy, although there isn’t enough evidence to support its usefulness. People with psoriatic arthritis need to work closely with a healthcare team to manage their condition and prevent joint damage. Please speak with your physician before embarking on any complementary treatment.
Peripheral neuropathy
Peripheral neuropathy is a condition in which the nerves that carry messages to and from the brain and spinal cord to the peripheries become damaged or diseased. The symptoms include numbness, tingling, burning and shooting sensations in the toes. In severe cases, it can lead to a complete loss of feeling in the feet. The most common cause of peripheral neuropathy in the toes is diabetes, alcoholism, vitamin B12 deficiencies, and certain medications.
Treatment for peripheral neuropathy includes medications to manage pain and improve nerve function and lifestyle changes such as maintaining a healthy diet and regular exercise. Again, it is critical to see a doctor if you are experiencing numbness or tingling in your toes, as early treatment can often help to prevent further nerve damage.
Questions your physician may ask to ascertain your toe pain causes
- When did you first start experiencing toe pain?
- How would you describe the location and intensity of your toe pain?
- Have you noticed any swelling or redness in your toe?
- Have you experienced any injuries or trauma to your toe?
- Do you have any underlying medical conditions, such as diabetes or arthritis, that could be contributing to your toe pain?
- Have you noticed any changes in how your shoe fit recently?
- Have you tried any home remedies or over-the-counter medications for your toe pain?
- Have you observed any patterns or triggers to your toe pain?
- Do you have any other symptoms in addition to the toe pain?
Questions to ask your physician about toe pain causes
- What is causing my toe pain?
- Could my toe pain be a result of an injury or trauma?
- Is my toe pain a sign of a more serious health issue?
- Are there any underlying medical conditions that could be causing my toe pain?
- Can my toe pain be treated with home remedies, or do I need medical attention?
- Are there any specific activities or behaviours that could be contributing to my toe pain?
Final thoughts
The causes of toe pain are myriad. The pathologies discussed above are just for reference. If you are suffering from any underlying medical conditions, you should see your physician for your toe pain. They will be able to assess your toe pain causes, treat it and help you prevent it from reoccurring. Remember, your health is your wealth!
