What Causes Toe Pain? 12 Possible Culprits (& What to Do)

Toe pain is commonly felt as a result of wearing inappropriate footwear, calluses, ingrown nails or bunions, Pain can also be a sign of illnesses or deformities that affect the joints and bones, like arthritis, gout or Morton’s neuroma. These conditions should be evaluated by a doctor, as they require specific treatment. 

Normally, toe pain can be relieved with rest, a foot soak or a massage with moisturizing cream. 

If your toe pain lasts for more than 5 days, you should see a doctor or physiotherapy to identify what is causing this symptoms. Treatment may involve medications, corticosteroid injections or physiotherapy. 

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Common causes

Toe pain can occur due to:

1. Tight shoes

Using tight shoes is one of the most common causes of toe pain. Tight shoes with a pointed toe or shoes that are very rigid can lead to foot deformity and joint swelling when used for prolonged periods. 

It is important to monitor children’s shoe sizes, as their feet are constantly growing. You should increase shoe sizes if the child reports foot pain. 

What to do: You should use comfortable footwear that are not tight on the foot. Shoes should have a small 2 to 3 cm heel to ensure adequate foot support.

2. Sprain or fracture

A toe sprain or fracture is also a common cause of toe pain. These conditions usually present with redness in the area and difficulty moving. 

What to do: It is important to see a doctor for assessment if you suspect you have sprained or fractured a toe. In some cases, the doctor may recommend orthopedic casts and physiotherapy to improve mobility in the foot and toes. Serious cases may require surgical repair. 

The doctor may prescribe analgesic and anti-inflammatory medications to help manage pain and swelling.

3. Bunions

Bunions cause pain particularly on the side of the foot, however they can sometimes cause toe pain as weather bunions, the foot bones are visibly unaligned, which can lead to pain and inflammation.

What to do: Apply a cold compress on the affected area to manage pain. There are some exercises that can help to prevent worsening, although surgical repair may be recommended for more serious cases.  

4. Callus

Calluses are made up of accumulate dead skin cells on the superficial layer of the skin. They build up due to constant pressure and friction in the area, and are particularly common on the side of the big toe. 

What to do: You can use an orthopedic insole to protect the callus throughout the day and prevent worsening when walking. Thick calluses can be removed using ointments and pumice stones after bathing. 

5. Ingrown nail

An ingrown nail can emerge if toe nails are not cut correctly. They can cause swelling and small wounds in the nail corners. 

What to do: You should see a podiatrist to treat ingrown nails. You can relieve pain in the meantime by soaking feet in warm water for 20 minutes. 

6. Arthrosis or arthritis

Rheumatic conditions, such as arthritis or arthrosis, can emerge on toe joints in athletes or older adults. This can cause pain with walking and joint swelling in the affected area. 

What to do: You should consult an orthopedic surgeon to initiate adequate treatment. The doctor may prescribe anti-inflammatories, like ibuprofen or diclofenac. In addition, you can soak your feet at the end of the day to relieve pain. 

Many patients may also benefit from an arthritis diet - read more about it here.

7. Hammer toe

Hammer toes are a foot deformity that disrupts proper toe alignment. They can increase pressure in specific areas, leading to pain. 

What to do: You should consult an orthopedic surgeon to repair the hammer toe using orthopedic splints. Insoles can also be used to relieve pressure in certain areas of the foot and reduce pain. 

8. Morton’s neuroma

Morton’s neuroma is a small mass that can grow on the plantar digital nerve between the 3rd and 4th toes. It can cause pain in this space, as well as a tingling at the top of the foot. 

What to do: You should use appropriate footwear with a insoles to relieve pressure in the area. You can also take prescription anti-inflammatories to help relieve pain and swelling, although more severe cases may require surgical intervention. 

9. Gout

Gout is an inflammatory disease caused by excess uric acid in the blood. It causes joint pain, particularly in the toes, as well as pain with walking, difficulty moving the toes, swelling and joint stiffness. 

What to do: Treatment for gout should be oriented by a doctor, who may prescribe medications to decrease uric acid levels in the joints (like colchicine, allopurinol or probenecid). These medications can help to relieve pain and prevent further flare-ups. Manintaining a gout diet may also speed-up recovery and relieve moderate symptoms.

10. Paronychia

Paronychia is an infection that affects the skin around a fingernail or toenail. It is usually the consequence of an injury (from a pedicure, for example). This wound can cause toe stiffening, swelling and pain, as well as discharge beneath or around the affected toenail. 

What to do: Treatment for paronychia should be oriented by a dermatologist, who may prescribe antibiotics, corticosteroids or antifungals, depending on the underlying cause and presenting symptoms. 

11. Reynaud’s disease

Raynaud’s disease is characterized by an abnormality in blood circulation to the hands and feet (although it can also affect the fingers, toes, nose, and ear lobes). This abnormality is associated with cold exposure and sudden mood swings, and can lead to symptoms like tingling, swelling and finger or toe pain.

What to do: Treatment for Raynaud’s disease should be oriented by a rheumatologist, who may prescribe medications like nifedipine, diltiazem, prazosin or topical nitroglycerin. You should warm up affected areas as soon as possible to promote circulation. 

12. Chilbains

Chilbains (or perniosis) is a condition that occurs due to prolonged cold exposure. It is characterized by narrowing of the blood vessels in the extremities, including the feet, which reduces oxygenation to the area. It causes symptoms like blisters, ulcers and toe pain. 

What to do: You should avoid cold environments and keep the skin dry and warm. If you experience any wounds, be sure to apply antiseptic to prevent complications. 

If any wounds do not heal on their own, you may need to see a doctor for more specific treatment to relieve pain and speed-up healing.