7 Common Causes of Big Toe Pain

Medically Reviewed By William C. Lloyd III, MD, FACS
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  • Your big toe does more work than you may realize—it bears about half your weight each time you take a step. Big toe pain can slow you down, making it tough to get around or even get a good night’s sleep. Several different conditions may be behind what’s making your big toe hurt. Here are some common reasons why it may be bothering you and treatments that can help relieve the pain.

  • 1
    man holding big toe and foot in pain

    Different types of arthritis can cause big toe pain. It may be osteoarthritis—“wear and tear” on the joint—which typically causes aches and early morning stiffness. Talk to your doctor about treatments including stretching exercises, over-the-counter pain medication, and possibly steroid injections. Rheumatoid arthritis is an autoimmune condition that inflames the lining of the joints and often starts in the feet. If you have RA in your big toe, activity may make it sore or painful. Your toe may even change shape over time. Treatment options to discuss with your doctor include rest, icing, compression, steroid shots, and long-term medications.

  • 2
    Hallux rigidus
    pain in the joint of big toe

    Hallux rigidus means “stiff big toe.” It can be due to arthritis, overuse or injury. If it’s not treated, the toe may become frozen, meaning the joint is so rigid it makes it hard to walk. If the pain may be from arthritis, see a rheumatologist who can confirm a diagnosis and recommend treatment. If you don’t suspect arthritis, you can try icing the toe and taking pain medication to relieve symptoms. If the pain persists, see a podiatrist who can recommend shoes with good support that don’t press on the toe, and discuss other treatment options.

  • 3
    Bone spurs
    Female doctor and male patient examining foot x-ray

    If the big toe pain is in a joint, it’s usually the joint that attaches the toe to the foot. When you push off to walk, the joint needs to bend. If you have a bone spur, a bony growth that projects from the top of the joint, it prevents the joint from bending properly. If icing, pain relievers, and well-fitting shoes don’t help, your doctor may recommend removing the spur so the toe has more room to bend. The surgery can take several months to heal, but it’s often effective in relieving pain and restoring mobility.

  • 4
    Turf toe
    gettyimages 769716965

    If you jam your big toe so that it bends back and up, you can sprain the main joint and develop “turf toe.” It’s a common injury that can also be caused by repeatedly pushing hard off the toe as you move. It got its name because it’s common among football players who play on artificial turf, which has less give than real grass, but it can happen to anyone. Treatments include the RICE method—rest, ice, compression, and elevation—and NSAIDs, or nonsteroidal anti-inflammatory drugs. In some severe cases, surgery can repair tissue and restore mobility.

  • 5
    closeup of man's foot with gout

    Gout is a very painful form of arthritis, and the big toe is a likely place for a gout attack. If you have high levels of uric acid, sharp crystals can form in your body and jab the joint. The crystals often form in cooler parts of the body, farthest from your heart. Gout often strikes suddenly at night or early morning, when your body temperature is lower. If you have a flare, rest and elevate your foot. Limit foods that are high in uric acid, such as meats, seafood and alcohol. There are effective medications to prevent and treat gout, and symptoms usually go away in a few days.

  • 6
    doctor checking patient's foot

    A bunion is a hard bump on the lower joint of your big toe that can become inflamed and painful. Bunions form when the toe is pulled toward the other toes. Tight shoes may cause bunions but they can also be due to arthritis or simply the shape of your foot. Bunion pads, pain relievers, icing or, if the pain is severe, cortisone injections can help. If you have bunions, talk to a podiatrist about shoes and supports that will distribute your weight evenly and reduce pressure on the big toe. Surgery is an option, though recovery can take months.

  • 7
    Ingrown toenails
    Ingrown Toenail

    An ingrown toenail is a nail that has grown into the toe itself, usually on the big toe. They can become painful, inflamed or infected. Ingrown toenails can form when you cut the nail in a curve rather than straight across, from shoes that are too short or tight, or in people who have strongly curved toes. Soak your toe in warm water and put a small bit of clean cotton under the nail to pad it. A podiatrist can trim the ingrown nail or may remove it along with part of the nail bed to keep it from growing back.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 13
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