The toes consist of multiple osseous and soft tissues including tendons, nerves, and ligaments, that support our body weight. Each toe has several small bones called phalanges that connect to metatarsals, the longer bones in our midfoot. Each toe is made up of three phalanx bones, which are the proximal, middle and distal, except for the big toe which only has two phalanges, the proximal and distal. The primary function of your toes is to provide posture and balance, support the body weight, and propulsion during the gait cycle. Not only do your toes help thrust your body forward when you walk, they actually help increase the length of your stride allowing you to run faster.
Toe pain is any uncomfortable sensation in the toes. You may feel irritated or debilitating when you attempt to put any pressure on your foot or toe due to this condition. Toe pain can come on suddenly and severely, or it may develop gradually over time. However, there are a lot of reasons you may have an aching toe.
There’s always the chance you stubbed it or banged it while playing certain sports activities. But there are also problems like hammertoe or arthritis that could be the result of the pain. If one or more of your toes are crooked or curled under, you may have a hammer, mallet, or claw toe.
Your foot has a unique shape because the muscles, tendons, or ligaments that surround your toe aren’t balanced. This causes the toes to bend in an odd position. Your toe may generally hurt. It’s also common to develop a corn or callus because the joint rubs the inside of your shoe. Each of the toe conditions mentioned earlier has its own distinctive appearance, such as described below:
- Hammertoe – The middle joint of your toe bends downwards. This causes your toe to rise up instead of lying flat. This condition typically occurs in your second, third, and fourth toes.
- Mallet toe – Your toe bends down at the joint closest to the nail. Like hammertoe, it often happens in your second, third, and fourth toes.
- Claw toe – In cases of a claw toe, your toes form a claw shape. The joint at the base of the toe bends up, while the two other joints bend down. This causes your toe to curl and dig into the soles of your shoes.
- Turf toe – Turf toe is a sprain to the joint at the bottom of your big toe. This injury causes pain and swelling while decreasing your ability to move your big toe. Walking or other weight-bearing activities can make it ache more.
Causes & Symptoms of Toe Pain
Toe pain can be caused by a wide variety of ways depending on which toe has been injured at the moment. Some potential causes of toe pain when walking are the result of broken, sprained, or dislocated toes, as well as corns and calluses. Arthritis can also be present when walking over time, which can make toe joints sore, swollen, and stiff. Certain toe conditions primarily affect the big toe. Some common causes of big toe joint pain include:
- 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 – An injury that can occur with the overextension of the big toe joint.
In addition, some painful conditions occur more often in your middle toes than in your big toe or pinky toe. These conditions include:
- Capsulitis – which refers to inflammation of the connective tissues where the toe joint meets the ball of the foot.
- Morton’s toe – The extension of the second toe past the big toe, which can lead to painful pressure and calluses.
- Plantar plate tear – This is the rupture of the thick, fibrous tissue that extends across the ball of the foot, frequently involving the second toe.
Right or left toe pain does not manifest in the same way for all patients. Variations result from what the cause of the toe pain is, which toe hurts, and at what times and during which activities the pain arises. Therefore, below are common symptoms linked to toe pain:
- Bruising
- Abnormal bending
- Tingling feeling that can become painful
- Limited range in motion of the affected toe
- Stiffness and pain when moving the injured toe
- Painful swelling
Who gets Toe Pain?
Risk factors associated with toe pain can lead to most conditions in strange ways, such as:
- Genetics – The shape of your foot and your gait can play a role in whether you develop toe pain and other foot conditions. This may be determined by your genetics.
- Stress – If you spend a lot of time on your feet at work or while playing sports, you might put too much strain and pressure on your toes and other areas of the foot. Without proper rest and stretching of the foot, this can result in toe pain and injury.
- Diabetes – Diabetes can lead to blisters and sores on the toes and other areas of the foot. If left untreated for too long, these blisters and sores may turn into ulcers.
- Shoes – High heels and tight shoes crowd the toes together and cause the muscles to tighten and shorten. In time, straightening the toes becomes impossible. Tight shoes can also cause ingrown nails and shoes that are too loose can provoke improper gait leading to a foot injury.
How Does Toe Pain Affect You? How Serious is it?
Different toe pain will have its own causes and risk factors; toe pain due to chronic or progressive conditions is likely to worsen if left untreated. If this occurs, chronic conditions can cause permanent damage or other complications. Therefore, it is important to seek immediate medical attention when you experience any of the complications mentioned below:
Broken bones
The toe bones are as fragile as they are strong. You might not immediately notice a fracture or breakage of the toe, so it is important to seek medical treatment after a harsh impact to the toe where pain does not dissipate.
Nerve damage
A common cause of nerve damage is Morton’s neuroma. In these cases, your toes could feel numb, or you might experience a tingling sensation. Burning pain or a feeling as if you are standing barefoot on pebbles is associated with nerve damage.
Arthritis
Arthritis can lead to complications with joints all around the body. Toe joints are easily susceptible to arthritis as your toes are used for everyday weight-bearing activities. One specific complication it can cause is hallux rigidus.
Irregular shape
Breaking of the toe, bunions, and other similar injuries to the toe can cause an irregular shape of your affected toe. The irregular shape can lead to discomfort while wearing shoes or pain when walking.
Recommended Treatment & Rehabilitation for Toe Pain
In order to accurately diagnose the underlying cause of toe pain, your doctor will begin by examining your toe and foot and ask you several questions related to your symptoms. He or she may also order an X-ray to determine if structural damage could be the source of the pain. If a broken toe is suspected, your doctor will most likely use multiple X-rays to get a clearer view of your foot taken from various angles.
If your toe has truly been broken, then surgery may be required. The most common type of surgery for broken toes is open reduction and internal fixation. To begin with the procedure, your surgeon will administer regional anesthesia. In some cases, sedation may also be provided.
Afterward, a small incision is created down the length of your toe to access the fractured areas. Your surgeon will then place the bone fragments in their correct positions, then secures them into place using surgical screws, plates, or rods. Lastly, the incisions are closed with surgical staples or sutures. The area is then covered with a surgical dressing and protected with a cast or a splint. Normally, the length of surgery depends on the extent of the damage. But in most cases, toe surgery can be completed in approximately two hours.
Immediately after a toe pain injury, the following treatment plans may help alleviate the pain and prevent further injury. A physiotherapist will be able to perform this treatment method known as the PEACE principle, such as described below:
- Protect – Your physiotherapist will limit movement and use pain as a guide to avoid causing discomfort.
- Elevate – He or she will put your feet up at about heart level to increase blood circulation.
- Avoid anti-inflammatory medications – Inflammation is the first stage of the body’s natural recovery process. You do not want to disrupt your recovery if you take anti-inflammatory drugs (NSAIDs).
- Compress – Putting pressure on the toe / foot (such as when using a compression sock) may help limit swelling. Too much compression can restrict needed blood flow. Your physiotherapist will choose the perfect amount of compression to help treat your toe injury.
- Education – Your physiotherapist will educate you about the injury and instruct you on an active approach to recovery and your options for treatment. He or she will also determine when it is safe for you to return to your regular activities.
After the treatments mentioned above have been achieved, your physiotherapist will work with you to design a proper treatment program specific to your goals to finish recovering from your toe pain. Some of these treatment plans may include:
Range-of-motion exercises
It is important to regain the full range of motion of your big toe and foot. If your injury required the use of a brace or boot to restrict movement during healing, your toe and foot joints may be stiff. Your physiotherapist will then teach you gentle stretching and movement exercises to help restore normal movement.
Muscle-strengthening
It is common to lose strength in the muscles of your foot, ankle, and leg after a toe injury. This is due to the change in activity and any bracing or boot used to restrict movement during healing. Your physiotherapist will determine which muscles are weak and teach you specific exercises to strengthen them.
Manual therapy
Manual therapy can be especially effective to restore movement in joints that become stiff after being immobilized. Your physiotherapist may gently move the joints involving your injury for you. This might feel like your foot is being gently wiggled.
Below are a few exercise examples for you to try at home:
Toe curl
Sit on the floor, with the heel of your affected foot on the floor. Next, gently curl your toes forward and then backward. Hold each position for about 6 seconds. Repeat 8-12 times a day.
Towel scrunches
Sit in a chair and place your affected foot on a towel on the floor. Then, scrunch the towel toward you with your toes then use your toes to push the towel back into place. Repeat 8-12 times a day.
Marble pick-ups
Put some marbles on the floor to lift up one marble from the floor at a time. Then try to put the marble in the cup. Repeat this method 8-12 times a day.
Towel stretch
Sit with your legs extended and knees straight. Next, place a towel or belt around your foot just under your toes. Hold both ends of the towel or belt, with your hands above your knees. Pull back with the towel or belt so that your foot stretches toward you. Hold the position for at least 15-30 seconds, then repeat 2-4 times a day.
Alternative & Homeopathic Treatment for Toe Pain
There are many different ways to ease your toe pain homeopathically. Some of these alternative treatments include:
- Ice application – An ice pack can help relieve toe pain. This option could be particularly useful for patients with foot pain in the joints of their feet due to trauma, infection, inflammation, or arthritis.
- RICE method – RICE stands for rest, ice, compression, and elevation. Many athletes tend to follow this method in order to rule out further symptoms linked to injured toe.
- Foot shower – Patients can bathe sore, painful, or tired feet in a bowl of warm water. Some individuals find that adding Epsom salts to the water can help ease the soreness much further.
- Fish oil – Omega-3 oils are perfect for supporting nerve health and preventing foot pain.
- Massages – Having a foot massage by a massage therapist can help seek out tender spots in your affected toe and other areas in your feet and press on them while gently stretching.