The majority of the time your big toe stays  out of sight and out of mind, hidden beneath our socks and shoes and it’s easy to forget how important it is. However, if you have ever had toe pain, you know it can keep you off your feet and up at night. This toe has to do a lot of work to allow us to walk and has to bear about 50% of your body weight every time you take a step.  

Possible causes of pain under your big toe: 

 Bunions 

Are your feet changing shape? Do you see a prominent bump at the side and base of your big toe? Do you notice any swelling at the base of the big toe? These are some signs indicating you have a bunion. There are a number of causes as to why you would develop a bunion including genetics, arthritis, and improper footwear. Bunions can be very painful, making it difficult to wear shoes or walk very far. 

Treatment options include ice-packs, orthotics, wider fitting footwear and strengthening the muscles around the big toe joint but if these fail to make a significant difference, surgery may be required to correct the problem. 

Ingrown Toenails

I like to call these in-groan toenails as they can become very painful. They can be caused by the shape of the nail, not cutting nails correctly, banging the toe of something or wearing shoes too tight. Treatment options include foot soaks with salt and avoid wearing tight fitting shoes. However, the affected area of the nail usually needs to be cut back by a podiatrist to get relief from pain. 

Corns & Calluses

Corns and calluses can be a source of pain in any area of the foot, including the big toe. These occurs when excess skin grows as a result of excess pressure (from improper footwear, for example).  Although they are usually harmless and easy to treat, they can be painful.

Gout

Gout occurs when there is an excessive amount of uric acid in the body. This crystallises and hardens, leading to pain that can last for weeks. Gout most commonly occurs in the middle joint of the big toe, which will appear red and swollen, as well as feeling stiff and painful. Although painful, gout does not pose a major risk of further complications. Treatment for this would include taking medication to prevent flare-ups of gout and  resting and icing area.  

Arthritis

A common culprit of big toe pain is arthritis.  The most common place to get arthritis in the foot is at the base of the big toe. The big toe is continually bending up and down as we walk making it prone to wear and tear. With arthritis, the cartilage that lines the joint gets damaged and this results in stiffening of the big toe. Common symptoms include big toe joint pain, especially during walking, inflammation and stiffness limiting how much the big toe can bend up. Treatment includes pain relief, ice, steroid injections, orthotics and wearing wider fitting footwear. 

These are just some of the most common causes of pain in the big toe.

Fortunately, most are nothing to worry about and can be treated in a straightforward manner.

If you don’t think the symptoms laid out above match your pain, or the pain hasn’t gotten any better it is recommended that you see a podiatrist to identify the issue as early as possible. 

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