The toes contain 14 bones, as well as joints, muscles, tendons, ligaments, nerves, and blood vessels. All of these structures are subject to injury, infection, and other conditions that cause pain.
For this reason, a variety of conditions can lead to toe pain. According to a paper in American Family Physician, these include bunions, arthritis, infections, and injuries. Serious conditions, such as peripheral artery disease, can also cause toe pain.
If you are experiencing persistent toe pain or pain with swelling, redness, and warmth, seek prompt medical care.
This article explores some common causes of toe pain, as well as at-home remedies and treatments for toe pain relief. It also describes some symptoms that may occur with toe pain, including possible life threatening symptoms.
Some common causes of toe pain, according to the American Podiatric Medical Association and the National Library of Medicine, include calluses, arthritis, and bunions.
However, infections and nerve conditions can also affect the toes. In particular, sores on your toes that do not heal properly may indicate poor blood circulation due to peripheral artery disease, which is a life threatening condition.
Below is a summary of some possible causes of toe pain that occurs when walking, big toe pain, middle toe pain, and more.
Causes of toe pain when walking
Some potential causes of toe pain when walking include:
- broken, sprained, or dislocated toes
- an ingrown toenail, especially with infection or when it rubs against a tight shoe
- corns and calluses
- hammertoe, which is a condition wherein your toe gets stuck in a bent-down position
- arthritis, which can make toe joints sore, swollen, and stiff
- tendinitis
- neuroma, which is a nerve tissue growth that can cause pain between your toes when walking
- nerve impingement or compression
- neuropathy
Causes of big toe pain
Certain toe conditions primarily affect the big toe. Some common causes of big toe joint pain include:
- gout, which is a type of inflammatory arthritis
- bunions, which are bony growths on the outside of your big toe joint
- hallux rigidus, which is a type of arthritis at the base of your big toe
- turf toe, which is an injury that can occur with the overextension of the big toe joint
Learn more about the common causes of pain in the big toe here.
Causes of middle toe pain
Some painful conditions occur more often in your middle toes than in your big toe or pinky toe. These include:
- capsulitis, which refers to inflammation of the connective tissues where the toe joint meets the ball of the foot
- plantar plate tear, which is the rupture of the thick, fibrous tissue that extends across the ball of the foot, frequently involving the second toe
- Morton’s neuroma, which is a nerve tumor that compresses the nerves between the third and fourth toes
- Morton’s toe, which is the extension of the second toe past the big toe, which can lead to painful pressure and calluses
Infection-related causes of toe pain
Toe pain may also arise from various infections, including:
- athlete’s foot
- an infection of a wound or other sore
- septic arthritis
- COVID-19, which can cause so-called COVID toes, which are pink, red, or purple toes that may swell, blister, or ooze pus
Depending on what is causing your toe pain, you may have other symptoms as well. These can include:
- a burning feeling or warmth in the joint
- cold toes
- deformity in the toe
- difficulty moving your toe, or joint stiffness
- numbness
- skin bumps or lumps
- skin discoloration, such as bruising, redness, or a purple color
- swelling
Life threatening symptoms with toe pain
In some cases, toe pain may occur due to a serious or life threatening condition, such as a
Seek immediate medical care (call 911) for toe pain that occurs along with other serious symptoms, including:
- a change in your consciousness or level of alertness
- confusion
- difficulty breathing, wheezing, or shortness of breath
- high fever, or fever higher than 101°F (38°C), and shivering
- a rapid heart rate
- streaks around the sore area or a lump
- swollen toes with discoloration or warmth
To diagnose the underlying cause of toe pain, your healthcare practitioner will examine your toe and foot and ask you
Some questions your doctor may ask include:
- What is the exact location of your pain?
- Describe the pain. When did it start? Is it sharp, dull, or burning? How severe is it (on a scale of 0 to 10, with 10 being the worst pain you can imagine)?
- What seems to make the pain worse? Is there anything you do that helps lessen the pain?
- Is the pain constant, or does it come and go?
- Are you experiencing any other symptoms, such as numbness, weakness, or fever?
Provide your full medical history, including details of any medical conditions, surgeries and treatments, family history, and a complete list of the medications and dietary supplements that you take.
Some people may receive a referral to a podiatrist. Podiatrists are physicians who specialize in diagnosing and treating conditions of the foot and ankle.
You can often treat toe pain using at-home, over-the-counter treatment. However, you should first check with your doctor if you have severe symptoms or any questions or concerns.
Some common relief measures for toe pain include:
- resting with your shoe off
- elevating your foot
- applying an ice pack wrapped in a towel for up to 20 minutes every few hours
- applying heat, which may help with arthritic toe pain
- taking medications to relieve pain and inflammation, such as ibuprofen (Advil, Aleve) or acetaminophen (Tylenol)
- loosely “buddy taping” the injured toe to an uninjured one for stability, with a cushion of gauze in between
- switching to wider shoes with thicker soles and heels no higher than 2 inches
Depending on what is causing your toe pain, your doctor may recommend:
- custom made orthotics to prevent foot irritation from rubbing against the inside of shoes
- specially made sandals and shoes with modifications
- foot braces
- injections of cortisone into painful toe joints
- physical therapy to strengthen the toes and improve function
Surgery is necessary in some cases. Procedures may include:
- joint repair, replacement, or fusion
- bone removal or extension
- plantar plate and other soft tissue repairs
- bunion removal
- ingrown toenail removal
- neuroma removal
- toe amputation, in cases of severe infection
You can prevent some causes of toe pain with self-care. Tips for toe pain prevention include the following:
- When clipping your toenails, cut straight across to avoid creating an ingrown toenail.
- Wear comfortable shoes that do not pinch or press your feet.
- Examine your feet daily for cuts or sores. This is especially important if you have nerve conditions that can cause foot numbness, such as peripheral neuropathy.
- For gout, avoid eating foods that trigger flare-ups, such as processed meats.
The potential complications of toe pain depend on its cause. Mild toe pain due to wearing ill-fitting or tight shoes usually responds to conservative treatment, such as switching to more comfortable shoes.
Toe pain due to chronic or progressive conditions is likely to get worse without medical treatment. Left untreated, chronic conditions can cause permanent damage or other complications. So, it is important to contact a healthcare professional when you experience any kind of persistent pain or other unusual symptoms in your feet.
When you have an accurate diagnosis, following the treatment plan your doctor outlines helps lower your risk of potential complications, such as:
- chronic pain
- disability
- toe loss
- permanent nerve damage
- the spread of infection
Toe pain can result from wearing ill-fitting shoes or having a serious underlying condition, such as peripheral artery disease.
Pain in the toe can occur alongside a range of other symptoms, including numbness, swelling, or skin discoloration.
If your pain is persistent or unusual for you, it is important to contact a doctor for an accurate diagnosis. They can recommend the best treatment options for the cause of your toe pain.
