7 Possibilities Why Your Big Toe Hurts

by Jul 1, 2021

Big toes may be small, but big toe pain sure isn’t! 

Despite the fact that we humans can’t, say, grab fruit or cling to tree branches with our feet like chimpanzees, our toes are still pretty important for maintaining balance and providing thrust when walking. So if your big toe is hurting, it’s important to find out what the problem is and deal with it as quickly as possible. 

Fortunately, we can help! Below are some of the most common reasons your big toe might be hurting—but of course, this is not an exhaustive list. If you live in Central Kansas, your best choice is to call the Community Foot Clinic of McPherson today for a professional examination.

Turf Toe

As you might expect based on the name, turf toe is a common injury in “turf sports” like football and soccer. However, it’s possible to develop turf toe from any sport or physical activity—running, dancing, or even our own favorite sport here in McPherson County, basketball.

Turf toe is really just a sprain of one or more of the ligaments that support the joint at the base of the big toe. Typically, it’s the result of hyperextending your toe past its intended range of motion.

A single traumatic incident—say a hit on the football field that sends your body one way while your toes are stuck in place—is usually to blame. However, turf toe can also develop slowly as the result of chronic overuse.

Telltale signs include pain, swelling, and limited joint movement. If it happens suddenly, the pain will likely be instantaneous, and it may continue to get worse and worse during the next 24 hours.

2 men in the middle of a soccer game

Stubbed or Broken Toes

You probably don’t need us to tell you what a stubbed toe is. Almost everybody has at least one or two vivid memories of a time when they smashed a toe into a wall, table leg, bed frame, threshold, raised curb—you get the idea.

Stubbed toes are almost always painful, accompanied by throbbing pain, localized swelling, and temporary difficulty with walking or wearing shoes. The good news is that most cases are relatively minor and can be alleviated by following RICE therapy (rest, icing, compressing/wrapping the toe, and elevating the foot, especially within the first 48 hours of injury).

That being said, stubs can also cause more severe problems that might need more direct treatment from our office, especially if there are any broken or dislocated bones. Call us immediately if you notice any of the following after your toe injury:

  • Severe pain and/or bruising
  • You can’t move the toe, or moving it causes increased pain
  • The toe appears deformed or out of place
  • Numbness or cold sensations
  • Unusually pale skin

Gout

Sharp, sudden pain in the big toe joint that strikes when you least expect it—sometimes even in the middle of the night—is one of the hallmark symptoms of gout. Often the pain and hypersensitivity can be so intense that even putting a sheet on top of your toe can hurt.

Gout is actually a metabolic condition that stems from the body’s inability to efficiently purge uric acid from the bloodstream. When uric acid levels get too high, it can start forming sharp crystals that deposit painfully in the tissues surrounding a joint. (Although any joint can technically be affected, the big toe is by far the most common.)

If you’re susceptible to gout attacks, foods and drinks that are rich in purines—red and organ meats, shellfish, alcoholic drinks, etc.—should generally be avoided, since purines are broken down into uric acid during digestion and can trigger gout attacks. You should also make sure to drink lots of water.

Osteoarthritis and Hallux Rigidus

The most common form of arthritis in the big toe is osteoarthritis, otherwise known as “wear and tear” arthritis. Osteoarthritis that occurs in the joint at the base of the big toe is often referred to by the medical name hallux rigidus. This condition often results in progressive stiffness in the toe and pain when walking, or even standing.

Over a long period of time, the soft, rubbery cartilage that provides shock absorption and reduces friction within your joint can “grind down” and deteriorate. The body has very limited ability to repair or replace cartilage, so once it’s gone, it’s gone. This can eventually lead to “bone on bone” grinding and painful stiffness in the affected joint.

Although this process can happen naturally over time, big toes are also vulnerable to post-traumatic arthritis, which is a subset of osteoarthritis affecting joints that have been previously injured. If you have a history of other toe injuries, the cartilage may wear down faster, leading to arthritic pain much earlier than elsewhere. The onset may be several years after the initial injury, but several years before other joints become arthritic.

Rheumatoid Arthritis

Another possibility is rheumatoid arthritis, or RA, which is joint stiffness caused by an inflammatory  response rather than wear and tear.

RA is an autoimmune condition in which the body mistakenly begins to attack its own healthy tissue. The joints that connect the toes to the feet are often among the first to develop pain and swelling, but RA can affect many other joints throughout the body, as well as other organs and systems (such as the eyes, heart, and lungs). 

Bunion

Bunions do more than hurt your big toe. They actually throw the entire toe out of alignment, so that a giant bump forms on the inside of the foot (it’s actually the displaced metatarsal head) and the toe itself drifts toward (and sometimes crosses over) the other toes.

A bunion is a progressive deformity that will only get worse with time—never better. The toe drifts further out of place, the bump gets bigger, the joint becomes stiffer, and it gets more painful and harder to walk.

Because it develops slowly, many people tend to ignore their bunion until the deformity becomes severe and painful. Don’t be one of them!

Seeking care as early as possible can help you, at the very least, slow the bunion’s progression and minimize the amount of pain that you feel. This can allow you to enjoy your favorite activities longer and delay the need for surgery for as long as possible.

Sesamoiditis

In the ball of your foot, you’ll find two tiny bones called sesamoids that are not directly connected to any other bones in your body via a joint. Rather, they are embedded in the flexor tendon, right below the joint at the base of the big toe.

The sesamoids act like a sort of pulley system that helps the big toe move smoothly, provides leverage during your push-off, and dampens impact forces to protect the head of the metatarsal bone.

If these bones are fractured, or the tendons that attach to them become irritated, it can cause not only pain, but difficulty with straightening or bending the toe.

a man holding his big toe in pain

What Can I Do About My Big Toe Pain?

As with any painful problem you might be experiencing with your feet and ankles, a visit to Dr. Timson at the Community Foot Clinic of McPherson should be high on your to-do list. We are experts at keeping the people of McPherson, Saline, Reno, Harvey, and nearby counties on their feet!

When it comes to big toe pain, many different conditions can produce very similar symptoms. However, the optimal treatment approach may be radically different depending on the precise nature of your injury or condition, as well as your personal activity goals.

The way we might manage an early-stage bunion, for example, may be quite different from what we’d recommend for turf toe or gout. Bunions, as a progressive deformity, require ongoing preventative management. Turf toe is a soft tissue injury that just needs the right time and care to heal, while gout often requires dietary modifications and medications.

In short, the earlier you stop by to get a thorough examination, accurate diagnosis, and personalized treatment plan, the better off you’re going to be in both the short and long runs. That means less pain, more activity, and fewer trips to the foot doctor. (Not that we don’t love seeing you, of course—but we’d rather you just stay healthy and pain free!)

To request an appointment with Dr. Timson, complete our online contact form or give our office a call at (620) 241-3313.

McPherson Office

316 W. 4th Street
McPherson, KS 67460
P: (620) 241-3313
F: (620) 241-6967

Herington Office

1005 North B St.
Herington, KS 67449
P: (785) 258-5130
F: (785) 258-5129

Hillsboro Office

108 S. Main Street
Hillsboro, KS 67063
P: (620) 877-4305

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