Has this ever happened to you? You get up in the middle of the night to go to the bathroom and then you ram your big toe into some furniture. Big toe pain can be excruciating. Whether you’ve felt a sudden jolt from stubbing your toe in the dark, experienced pain from an ingrown toenail, or injured your toe playing sports, you know what I’m talking about.

Let’s take a look at 7 common reasons for big toe pain and what you can do to treat and prevent it.

Stubbing Your Toe

The first is stubbing your toe. While this may seem like a fairly minor injury, it’s still important to see your podiatrist to ensure it isn’t fractured or infected. In addition to pain, you may also notice bleeding under the nail, bruising, and redness on your skin, swelling, and difficulty putting weight on your foot.

Some things you can do at home include Rest, Ice, Compression, and Elevation.

  • Rest--It’s important to stop any physical activity and rest your foot.
  • Icing your toe. Use a cold compress or frozen peas 20 mins and 20 min over over the next couple of hours.
  • Compression. Use an elastic bandage to wrap your foot to reduce swelling.
  • Elevation – keep your foot above your heart.

You can also try buddy-taping your big toe to your 2nd and even your 3rd toe using athletic tape. You may also need to wear a walking boot if you podiatrist recommends it.

To prevent a toe injury be sure to wear supportive, closed-toed shoes and consider using a night light in your bedroom.

Ingrown Toenails

Ingrown toenails are another very common reason for big toe pain. Risk factors for ingrown toenails are wearing shoes that are too short, trauma to the nail, and improperly cutting the toenails. We treat ingrown toenails in our office with a same-day surgical procedure.

Next, If you’re an athlete you may have experienced an injury called Turf Toe. It’s very common among football and soccer players, but is also seen in gymnasts and dancers. It occurs when the toe bends too far or with too much force.

Symptoms can include:

  • Pain and tenderness
  • Swelling and bruising
  • Limited range of motion
  • An unstable toe joint.

Immediate treatment is the same as for a stubbed toe.  Rest, ice, compression, and elevation.

Treatments at our office can include custom orthotics, treatment with MLS laser to reduce pain and inflammation, and referral for physical therapy. Wearing supportive shoes will help with the treatment and prevention of this condition.

Without treatment this condition can lead to long-term stiffness in the big toe, called Hallux rigidis.

Tennis Toe or Runner’s Toe

While tennis toe occurs in tennis players and runner’s toe in runners this condition is also common in other sports like pickleball, racquetball, soccer, hiking, and skiing. It occurs when the toenail hits the top of the shoe repeatedly.

The primary symptoms are pain and bleeding under the nail which will cause the nail to turn black or purple. To treat it keep the area clean and covered and use an antibiotic ointment. Keep the nail attached as long as possible if you notice it coming loose.

While treatment of tennis toe is very simple, this condition can also lead to toenail fungus. a much more difficult condition to treat. You can learn more about that condition in the description below.

To prevent tennis toe, keep your nails trimmed and wear shoes that fit. If you have trouble keeping your foot from sliding forward, use a lace lock or heel lock lacing technique. I’ll put a link about this technique in the description below.


Sesamoiditis is an overuse injury characterized by chronic inflammation of the sesamoid bones and the tendons that connect them. The sesamoids are two pea-shaped bones located beneath the big toe joint in the ball of the foot.

Increased pressure on the sesamoids, which is common in ballet dancers, runners, and baseball catchers is the primary cause of this condition. Women with high arches who wear high heels are also at risk.

Symptoms include pain under the big toe or ball of the foot, difficulty bending the big toe, and swelling and bruising.

In addition, to many of the same treatments I’ve already mentioned for other big toe pain conditions, padding can be used to relieve the area of tension under the sesamoids. We can also use cortisone to reduce the swelling.

Hallux Rigidus

If turf toe or even a stubbed toe goes untreated it can progress to a condition called Hallux Rigidus, a very painful condition of the big toe. It has several other causes including:

  • Overpronation
  • Too much stress on the big toe through work or sports
  • Conditions such as rheumatoid arthritis or gout

Symptoms you’ll notice are pain and stiffness particularly when you walk or run. These symptoms will be mild at first and become more pronounced over time.

The primary treatment for hallux rigidus are custom orthotics which control the foot biomechanics and the pain. I recommend rocker bottom shoes to my patients to reduce the amount of bend in the toe joint. Some great options are Hoka, New Balance 928, Dansko, and Alegria.

Surgery may be necessary if none of these conservative treatments relieve the symptoms.


Gout is a painful inflammatory condition caused by a buildup of uric acid in the joints. Patients won’t experience the symptoms of gout all the time but will experience gout attacks. These painful symptoms are most often brought on by eating foods that are rich in purine such as red meat, liver, shellfish, red wine, beer, drinks high in fruit sugar, and some medications.

People can also be at risk for this condition if they are overweight, have congestive heart failure and high cholesterol, diabetes, kidney disease, or high blood pressure.

Controlling gout includes avoiding the foods and drugs that can increase uric acid levels and taking medications to lower these levels. To learn more about how to reduce your risk for gout click on the link below.

In summary, big toe pain can put a crimp in your lifestyle by making it difficult to walk and play sports. Even if you think your big toe pain is minor, it's still important to come in and get it evaluated so that it doesn’t progress to something much worse that can be hard to treat later.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.