You get up in the middle of the night to go to the bathroom and you accidentally slam your big toe into your dresser. Yikes!
You are not alone. We've all done it. Hundreds of patients a year come in to see me with a stubbed toe. Although seeking medical attention for something as common as a stubbed toe may seem strange, it's best to come in to be sure the toe isn't fractured or infected if swelling or bleeding occurs.
In addition to a stubbed toe there are six other reasons why your big toe is killing you.
An ingrown toenail is another extremely common cause of big toe pain. Family history, trauma, short shoes, and improperly cut toenails can all lead to an ingrown big toenail. Fortunately surgery can be done right in the podiatry office. Most patients feel little pain and can start their usual activities the next day. Our office sees a lot of kids with ingrown toenails. To help prevent it, make sure your kids aren't outgrowing their shoes. Adults need to make sure to cut their toenails straight across only.
Turf toe most often occurs in athletes. It's very common in football kickers but can occur in any game where players jam their toe or repeatedly push off during running and jumping. The term was originally coined with sports played on artificial turf; the harder artificial surface makes cleats more likely to stick. However, turf toe can also occur on grass surfaces, particularly when the shoe worn is not supportive.
Tennis has its own specific toe injury caused by the fast changes in direction and the toe pushing against the toe box. Damage can result in the area underneath the toenail. It often gets worse with time. Preventing this injury is very straightforward. If you play tennis, keep your toenails short and wear tennis shoes that fit.
This is an overuse injury involving chronic inflammation of the sesamoid bones and the tendons involved with those bones. The sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. Sesamoiditis is caused by increased pressure to the sesamoids frequently seen in ballet dancers, runners, and baseball catchers. People with high arches who wear high heels are also at risk.
Hallux limitus and rigidus
Hallux stands for big toe. You might guess from the names that limitus means "limited movement" and rigidus means "a rigid, inflexible toe". Both of these conditions can be quite painful since we use our big toes for all of our mobile activities.
Usually a person with this condition starts out with hallux limitus which can progress to hallux rigidus. Both are forms of degenerative arthritis and can be inherited but can also develop from trauma to the big toe. Early treatment is important to prevent it from getting to the rigid stage. Wearing orthotics, anti-inflammatory treatments, and rocker bottom shoes are all effective treatments.
Gout is caused by a buildup of uric acid (a normal byproduct of the diet) in the joints. The big toe joint is most commonly affected, very likely from the pressure during walking and because uric acid crystals build up in the coolest part of the body. Attacks of gout are extremely painful and can be triggered by diets high in purines such as those found in red meat, organ meats like liver and kidney, shellfish, red wine and beer. Avoiding these foods and certain medications and drinking plenty of water are the best ways to avoid this condition.