Big Toe Pain

By Barbara Hales, M.D.
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Big Toe Pain

The big toe is important as the foreman of our daily physical activities, helping us stay balanced, and directing the way we walk by allowing us to push-off the ground. A painful toe restricts our activities.

Pain in the big toe (Hallux) is a symptom that often reflects a basic ailment affecting the bones or joints like:

  • Gout
  • Fracture due to trauma
  • Osteoarthritis
  • Rheumatoid arthritis
  • Bunions
  • Inflammation of ligaments and tendons around the toe
  • Hallux Rigidus
  • Bone tumor

Often, accompanying symptoms give us a clue as to the cause of big toe pain.



Redness, drainage, swelling Infected ingrown toenail
Swelling and bruising Trauma
Cold toe, discoloration Rule out blood clot or decreased blood supply to the area
Redness and sudden pain to the first joint Gout from rising uric acid levels
Joint pain Osteoarthritis, rheumatoid arthritis

If these symptoms are new, seeking immediate attention from a specialist can diagnose and treat the problem thereby alleviating big toe pain.

See Your Doctor Early

By getting diagnosed and treated with the onset of your problem, you decrease the possibility of the condition’s progression, which lowers your risk of surgery for in the future.

Diagnosis of Big Toe Pain

A physical examination will be performed after a thorough discussion of symptoms, medical history and activities.

Additional tests may be ordered for proper evaluation such as blood samples (to rule out gout or infection) and radiological tests. These tests consist of:

  • X-rays (to rule out fractures, arthritis, tumors, dislocations)
  • CT scans, also known as computed tomography, combines computer images and x-rays to show more detailed than an x-ray alone. A narrow x-ray beam circles around the body part for evaluation, giving a series of images from different angles
  • MRIs, also known as Magnetic resonance imaging, take images using a combination of radio waves and magnetic fields. Results are more detailed than x-rays or CT scans, permitting the radiologist to view cross-sections of the body.

Treatment of Big Toe Pain

Treatment will depend on the cause and intensity of your pain.

Initially, when the pain is mild, non-prescription medication like ibuprofen can decrease pain and inflammation. Choosing wider shoes or shoe inserts and padding may also help.

The RICE method is often advised which stands for Rest, Ice, Compression and Elevation to give pain relief.

Medical recommendations for moderate to severe pain involve:

  • Prescription pain or anti-inflammatory medication
  • Corticosteroid injections
  • Daily stretching exercises
  • Physical therapy
  • Dietary changes
  • Medication for gout if needed
  • Antibiotics for infections
  • Nail border removal for ingrown toenail

Surgical recommendation may be given for bunions or hallux rigidus. Get a vascular specialist consultation if poor circulation is suspected.

Prevention of Big Toe Pain

Here is a strategy for preventing big toe pain:

  • Wear comfortable shoes that provide balance, support and stability.
  • Drink plenty of fluids during exercise or activities
  • Improve your diet
  • Exercise your feet and legs to maintain muscle strength
  • Get regular checkups
  • See a foot specialist at the onset of symptoms