Acute great toe (Hallux) pain is a common complaint for many people. People wonder if it is normal to have pain on the big toe for a long time?
This is the subject I see internet users search for information about different big toe pain. So, you are not alone!🤦
Here are some of the common concerns asked by internet users on Google, about big toe pain.
So, for this reason.
I have decided to devote this article to discuss possible Pathological conditions that are associated with big toe pain.
These can vary from acute trauma to acute exacerbation of underlying chronic conditions.
As usual to provide you with information as precise and objective as possible, I rely on
⚫My knowledge as a diagnostic radiographer who x-rays toe issues.
⚫Research carried out in medical international scientific articles.
All references at the end of this article.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: March, 2025. Written by Juliet Semakula, a diagnostic radiographer.
Disclaimer: Amazon affiliate links, complete disclosure in the legal notice notice:
Summary: Big toe pain can indicate an injury or underlying health condition. Treatment is normally non-surgical; it is important to seek medical check up if your pain persists.
▶️What causes pain in the big toe?
Pathologies involving the great toe can be divided into acute and chronic lasting less than 6 weeks. (Andrews, 2021)
1️⃣Acute conditions of the great toe include hallux fractures, dislocations, turf toe, ingrown toenail, and various acute sesamoid disorders
2️⃣Chronic pathologies affecting the big toe include hallux rigidus, hallux valgus, and chronic sesamoid disorders such as gout or rheumatoid arthritis
A recent prevalence date from the Framingham Study reported that 19% of men and 29% of women reported foot pain on most days of the month, with prevalence of pain at specific foot locations ranging from 7% to 13%
You will experience pain in different locations of your toe
Image showing different toes images and prevalence of pain in each location.
Research done by Riskowski,2012
Showed, 75% of the population wear inappropriately sized footwear (tight shoes in patients with bunion and arthritis of the great toe) potentially contributing to forefoot pain (Riskowski, 2011)
▶️ What are the different types of pain of the big toe and the possible causes.
Big toe pain when walking (a fracture or arthritis)
When you feel pain when walking in your toe this could be a possibility of different things.
1️⃣Fracture: If your toe is painful, red or bruised when walking it could be that you have: fractured, sprained or bruised it.
Whatever case it may be, do not worry, treatment is usually the same.
Patients I have seen with this kind of pain, they usually get an x-ray to rule out a fracture. They are usually sent home with instructions to help with their healing.
🔵They are given painkillers to help with the pain
🔵 Advised to rest the foot and keep it elevated to help with the swelling.
🔵Hold an ice pack wrapped in a towel on your toe for up to 20 minutes every few hours.
🔵Strap up your broken toe to support the sore toe
🔵Avoid weight bearing on the affected toe
🔵Wear comfortable shoes
Riskowski, 2011
However, if you have fractured your toe seek medical help, do not strap up the toe, if it’s pointing out at the old angle and do not put ice.
Here is an article dedicated to fractured toes recovery timeline.
Throbbing pain in big toe at night
Pain in the big toe at night may be caused by circulating issues when blood is not reaching your toes or inflammation issues.
2️⃣This can be caused by inflammation of the joints which could be due to rheumatic conditions such as Osteoarthritis or joint wear and tear.
Hallux Rigidus is an osteoarthritis of the first metatarsophalangeal (MTP) joint.
This disorder is characterized by osteophyte formation on the dorsal aspect of the joint space that progresses to incorporate the entire joint margins (Kon,2017)
Osteoarthritis of the big toe (hallux rigidus) results in loss of movement and it can make it difficult to wear certain shoes and walk as you did before.
Common symptoms of hallux rigidus are:
🟢Stiffness and swelling in the joint
🟢Enlargement of the joint.
🟢Bending or associated deformity
When your pain persists for more than a week it is important to get your toe checked. It could be something serious.
Tips to help with throbbing toe pain at night
🟢Raise and rest your foot when you can.
🟢You can apply an ice pack to the affected toe.
🟢Shoe modifications and orthotics can reduce pain and limit the dorsal irritation and bending of the great toe.
Pain of hallux rigidus is sometimes misdiagnosed as gout because some symptoms are similar ( Kunnasegaran,2015)
Here is an article about osteoarthritis of the knee that may be of interest to you.
Pain, pus and swelling in the tip of big toe when touched.
3️⃣This could be a possibility of ingrown toenail, where the nail grows into the toe. You will feel pain and discomfort when walking.
🔴Your toe will look red and swollen it may also bring out pus and be hot to touch, this is a sign of an infection.
🔴Excessive sweating in the toenail and nail apparatus abnormalities.
Diagnosis is usually evident, but it should be differentiated from subungual exostosis and tumours of the nail bed (Khunge,2012)
Treatment options: can be conservative or surgical
There are various methods to treat ingrown toenail. The selection of technique depends on the stage and severity of the condition,
Mild to moderate lesions with minimal to moderate pain, little erythema and no purulent drainage can be treated with conservative therapies.
🟢Wear proper footwear
🟢Proper trimming of nails
🟢Address any other underlying pathogenic such as hyperhidrosis
🟢Soak your foot in warm salty water to help soften the skin around the toe and this may reduce infection.
🟢Keep your feet dry.
🟢Your doctor may suggest painkillers to help with your pain.
Moderate to severe lesions with severe, disabling pain, substantial erythema and purulent drainage usually require surgical intervention such as
🟢Excision of the spicule and partial matricectomy.
There are various surgical treatment options for ingrown toenails, although none of the techniques have been able to establish themselves as the technique of choice.
Sudden sharp joint stinging pain, swollen, stiffness, red or hot in toe
4️⃣This could be a possibility of gout which is a type of arthritis that causes sudden, severe joint pain.
Who gets gout?
When you have too much uric acid in your blood, this can lead to crystals forming around your joint which will cause sudden joint pain (Meiner,2001)
People with a higher chance of getting gout are those who:
♦️Drink a lot of alcohol,
♦️Take certain kinds of medications.
♦️Overweight.
♦️Have certain conditions such as diabetes, kidney problems, high cholesterol and if you have had surgery or an injury.
🟢Your big toe may feel hot, swollen and red skin over the affected joint.
🟢If the pain gets worse with a temperature and lost appetite this can mean you may have an infection inside your joint.
It’s important to seek medical treatment because leaving gout untreated may cause lasting damage to the joints.
If your doctor confirms its gout in your toe, you may be prescribed the following treatment options
🟢Non-steroidal anti-inflammatory such as NSAID like ibuprofen.
🟢Steroids tablets or an injection if the pain and swelling does not improve.
🟢You will be advised to rest your feet.
🟢Keep the joint cool by applying an ice pack wrapped in a towel.
🟢Try to drink lots of water unless you are told water is not good for you at this moment.
🟢Keep the toe dry and open, minimise covering the affected toe.
🟢Eat a healthy diet.
🟢Loss weight if you need to and reduce alcohol intake.
Meiner,2001
Caution! Avoid putting pressure on the affected toe joint, this will increase your pain.
A popping feeling limited stiff movement with pain in the big toe.
5️⃣This could be a possibility of turf toe, an injury to the ligaments around the toe.
It occurs commonly in sports injury due to repeated stress on the joints.
It can sometimes be mistaken for gout in the big toe because some symptoms are similar.
Treatment for a turf toe will require a medical examination, The treatment of turf toe injuries are graded into 1 to 3 based on how severe the joint is affected.
For grade 1️⃣ mild injuries: The aim will involve protecting the toe by
🟢Resting, applying ice, compression and elevation of the foot
For grade 2️⃣: Turf toe injuries may require you to wear a special walking boot for one week to help the plater complex together while it heals.
For grade 3️⃣: Injuries, you will be advised to minimize toe movement to all tissue and joint repair. You will be given a walking boot or cast sometimes surgery may be necessary for severe injuries.
McCormick,2010
Regardless of the grade of injury you may have, you may need rehabilitation under the guidance of a physical therapist or athletic trainer before you resume your normal activities.
Gradual toe pain that comes and goes with swelling and difficulty to bend could be a sign of sesamoiditis.
6️⃣Sesamoiditis: These are bones that connect to the tendon. When the tendon around the sesamoid below the big toe becomes inflamed or irritated.
🟢You will feel pain gradually particularly on the bottom of the toe and worse with weight bearing.
🟢Your toe may show some bruising, swelling and problems straightening or bending the affected toe.
People complain of pain being gradual, it will come and go because sesamoiditis develops over time.
🟢The discomfort can cause you to limp when walking.
Caution! These sesamoiditis bones are subject to fracture which sometimes makes it difficult to see the difference.
So, it’s important to seek medical assessment, normally you will get an x-ray to examine the toe and other tests.
Treatment options of a sesamoiditis
🟢Reducing activities on the toes
🟢Wearing comfortable soft-soled, low-heeled shoes.
🟢 Inserting a cushioning insole inside the shoes.
🟢Your doctor may prescribe you pain medication or an injection to help stop inflammation in the tendon.
🟢In some cases, the doctor will advise you to tap the large toe in a slightly downward manner to stretch and relieve pressure on the toes
Andrews,2021
Big toe lump, pain, redness and irritation when walking.
7️⃣This could be caused by a bunion (hallux valgus) which is a common foot deformity where the big toe joint protrudes out of its normal position.
They form when the ligaments, tendons, and bones around the joint become weakened, allowing the toe to drift outward.
🟢This causes a lump of bone and tissue to form on the outside edge of the foot, which can lead to pain, redness, and irritation.
🟢Bunions are caused by several factors, including wearing poorly fitting shoes or high heels.
Treatment options may be surgery or conservative management such as:
🟢Rest, ice and in some cases use a bunion sleeve on your big toe to help with recovery. You can find these on Amazon or any store of your choice.
Image showing a bunion sleeve worn on the big toe.
▶️How long does healing take for big toe pain and symptoms to heal?
How long it takes for a big toe to heal will depend on:
🟢The kind of treatment performed on your toe.
🟢Individual condition, remember we all heal differently.
🟢What is meant by healing, no pain or any symptom at for a week or for a month.
Assuming you have followed your doctors’ instructions and done everything right regarding your treatment.
It usually takes 4 to 6 weeks for complete big toe healing, most pain and swelling will go away within a few days to weeks, in some cases even months.
Always consult your doctor for advice if your symptoms persist. Do not ignore big toe pain, it could be something serious.
You might also like these articles:
⚫Fractured toes, treatment and recovery timeline.
⚫Numbness and tingling feet: why and what to do?
⚫Should I be concerned if one of my feet is swollen?
We have come to the end of this article; hope you have got answers to some of your questions.
Wishing you a quick recovery!🙋
📚Sources:
McCormick JJ, Anderson RB. Rehabilitation following turf toe injury and plantar plate repair. Clin Sports Med. 2010 Apr;29(2):313-23, ix. doi: 10.1016/j.csm.2009.12.010. PMID: 20226323.
Andrews NA, Ray J, Dib A, Harrelson WM, Khurana A, Singh MS, Shah A. Diagnosis and conservative management of great toe pathologies: a review. Postgrad Med. 2021 May;133(4):409-420. doi: 10.1080/00325481.2021.1895587. Epub 2021 Apr 4. PMID: 33622169.
Riskowski J, Dufour AB, Hannan MT. Arthritis, foot pain and shoe wear: current musculoskeletal research on feet. Curr Opin Rheumatol. 2011;23(2):148–155.
Kon Kam King C, Loh SY J, Zheng Q, et al. Comprehensive review of non-operative management of Hallux Rigidus. Cureus. 2017;9(1):1–14.
Kunnasegaran R, Thevendran G. Hallux Rigidus: Nonoperative Treatment and Orthotics. Foot Ankle Clin. 2015 Sep;20(3):401-12. doi: 10.1016/j.fcl.2015.04.003. Epub 2015 Jun 9. PMID: 26320555.
Khunger N, Kandhari R. Ingrown toenails. Indian J Dermatol Venereol Leprol. 2012 May-Jun;78(3):279-89. doi: 10.4103/0378-6323.95442. PMID: 22565427.
Meiner SE. Gouty arthritis: not just a big toe problem. Geriatr Nurs. 2001 May-Jun;22(3):132-4. doi: 10.1067/mgn.2001.116378. PMID: 11410763.
Image from https://www.healthline.com/health/sharp-pain-in-big-toe#causes