There are numerous potential causes of pain in your big toe, as well as inflammation and reduced mobility.

When you experience joint pain in your big toe, your first thought might be arthritis. For more acute symptoms, you could be concerned about a fracture or sprain.

While all of these are possibilities, there are multiple possible causes of big toe pain. Learn more about your risk for these conditions, as well as how to prevent and treat joint pain in your big toe.

Consider the following possible causes of joint pain in your big toe, including symptoms, risk factors, and prevention strategies.

Gout

A type of arthritis, some of the classic symptoms of gout include a sudden onset of symptoms that affect your big toe joint. These include pain, stiffness, and inflammation. Your toe may also appear red from swelling. Gout symptoms usually last for 1–2 weeks at a time.

Risk factors and triggers

Gout is caused by a buildup of urate in your body, which can eventually lead to the formation of painful crystals called tophi. These crystals can form on your joints and other areas of your body like your kidneys.

Urate is made in the body when you consume purines. Consuming too many purine-containing foods, such as meat, may increase your risk of developing gout. Other risk factors include:

  • increasing age
  • having a family history of gout
  • being male
  • regular alcohol or sugar consumption
  • certain underlying health conditions, such as kidney disease, metabolic syndrome, and high blood pressure
  • taking certain medications, such as diuretics, immunosuppressants, and aspirin

Preventing gout

You may be able to prevent gout with dietary changes, such as eating more plant-based foods. Weight management, blood pressure control, and other medical strategies may also help.

Other forms of arthritis

While gout commonly affects the big toe, there are other forms of arthritis that might affect these joints, too. You might feel pain, stiffness, and swelling that worsens upon waking up or after resting.

Risk factors and triggers

Several types of arthritis may affect your toe joints. These include osteoarthritis (OA), which can develop from wear and tear or years after an injury.

Certain inflammatory autoimmune diseases can also cause arthritis in your big toe. These include:

Preventing other forms of arthritis

Arthritis isn’t always preventable. However, you may possibly reduce your risk by eating a healthy diet, managing your weight, and quitting smoking, if you smoke. Quitting can be difficult but a doctor can build a plan that works for you.

Bunion

A bunion is a bony lump along the outside of your big toe that is hard and painful to the touch. Bunions develop gradually as your big toe drifts toward your outer foot, along with your smaller toes.

Risk factors and triggers

You may be at risk of developing bunions if you have a family history of them, or if you wear heeled shoes with narrow toe boxes on a regular basis.

Preventing bunions

You can help prevent bunion development by wearing wide shoes that properly accommodate all of your toes. This reduces pressure on your big toe.

Hallux rigidus

Hallux rigidus describes big toe joint stiffness. It’s a common type of arthritis of the foot that primarily affects the joint in the base of your toe. Over time, a swollen bump may develop over the joint.

Risk factors and triggers

Hallux rigidus is most common in adults 30–60 years old. Risk factors include previous injuries, bunions, and flat feet. It also sometimes runs in families.

Preventing hallux rigidus

While not all cases of hallux rigidus are preventable, you can help reduce your risk by wearing good shoes. Ideally, these should have large toe boxes. If you have flat feet, a doctor may recommend inserts.

Sesamoiditis

Sesamoiditis is a condition that causes inflammation in sesamoids, or certain bones that are connected with tendons rather than other bones. These can include sesamoids surrounding your big toe.

Sesamoiditis primarily causes pain underneath your big toe and the ball of your foot.

Risk factors and triggers

Risk factors for sesamoiditis include anything that places pressure on the ball of your foot. This can include wearing high heels or engaging in certain activities like frequent running.

Preventing sesamoiditis

You may be able to reduce your risk of developing sesamoiditis with activity modifications as well as wearing shoes with soft soles and low heels.

Turf toe

Turf toe describes a sprain in the metatarsophalangeal (MTP) joint located in your big toe. This type of injury occurs when you bend your big toe back toward your foot too far, which is common in athletes. This can cause pain and swelling in the MTP joint.

Risk factors and triggers

Turf toe is common in athletes, particularly those who play high impact sports like football or basketball. The risk is even greater if you run on artificial turf because of a lack of rigidity of the ground against your feet.

Preventing turf toe

One of the best ways to prevent turf toe is to run and play sports on natural turf only.

Ingrown toenail

An ingrown toenail develops when the corner of a nail grows into a toe. This can cause pain, redness, and swelling where the nail curls back into the skin. It’s also most common on your big toe.

Risk factors and triggers

Anyone can get an ingrown toenail. Some risk factors include wearing too-tight shoes and cutting your toenails too short.

Preventing ingrown nails

You can help prevent ingrown nails by cutting your nails straight across and not curved around the edges. Also, be sure to keep your feet dry and clean and wear shoes that don’t rub up against your toes.

Fracture

A broken toe can lead to significant pain and reduced mobility as your injury heals. If your big toe is broken, you may also notice redness and bruising.

Risk factors and triggers

Your big toe may break from a sudden injury, such as stubbing it on a piece of furniture or having a heavy object fall directly onto your toe.

Preventing fractures

Wearing shoes is the best way to prevent fractures. Also, take care when lifting heavy objects so that they don’t fall on your feet.

Raynaud’s

Raynaud’s phenomenon is a condition where blood stops flowing to your toes and fingers. This can include your big toe. Aside from pain, Raynaud’s can also cause feelings of pins and needles, skin color changes, and numbness.

Risk factors and triggers

Symptoms of Raynaud’s are often triggered by stress, anxiety, and sudden temperature changes due to weather or air conditioning.

Preventing Raynaud’s

You may be able to help prevent Raynaud’s by keeping your feet warm. This includes wearing socks and using an extra blanket on your feet while sleeping.

Regular exercise may also improve circulation to prevent symptoms. Additionally, a class of drugs called vasodilators may prevent Raynaud’s episodes by keeping your blood vessels open to blood flow.

Some of the same conditions that cause joint pain in your big toe may also cause throbbing — and sometimes sudden, sharp pain at night. These may include:

  • gout
  • sesamoiditis (in the case of a sesamoid fracture)
  • ingrown toenail (this may indicate an infection)
  • a broken toe

Some of these same conditions may cause sensations of needing to “pop” or “crack” your big toe joint. These include:

  • OA
  • Hallux rigidus
  • turf toe
  • broken toe

Big joint pain when walking may be caused by:

  • gout
  • other types of arthritis
  • bunions
  • hallux rigidus
  • sesamoiditis
  • turf toe
  • ingrown toenail
  • a broken toe

Consider contacting a doctor if the pain in your big toe has lasted for longer than 2 weeks. You should also get medical help if the pain prevents you from walking, if the pain in your toe comes and goes, or if you have any known underlying medical conditions like diabetes.

A doctor may diagnose the underlying cause of joint pain in your big toe with the following strategies:

  • taking a history of your symptoms
  • physical exam
  • imaging tests, such as x-rays
  • blood tests to help rule out an autoimmune disease, or to confirm gout

While the exact treatment of joint pain in the big toe varies on type and severity, possible options may include:

Home remedies

  • rest
  • icing your toe for 20 minutes every 3 hours
  • gentle stretches
  • wearing different shoes, possibly with padding
  • wearing a protective boot

OTC medications

Over-the-counter (OTC) pain relievers like topical or oral ibuprofen may help alleviate inflammation and pain associated with arthritis and other causes of joint pain.

Prescription medications

Prescription topical pain relievers, steroid injections, and oral anti-inflammatories might be needed to reduce inflammation and pain. In the case of gout, urate-lowering medications may be prescribed.

Surgery

A doctor may suggest surgery for significant problems with your big toe that don’t respond to other treatment methods. Surgery may be an option for bunions, hallux rigidus, sesamoiditis, and severe arthritis.

Physical therapy

This can complement other treatments for more chronic conditions, such as arthritis, that cause joint pain in the big toe.

Many of the underlying causes of big toe joint pain can go away with rest and home remedies, while others, such as arthritis, may require ongoing treatment and management.

If you’re experiencing severe toe pain, or pain in your big toe that doesn’t improve after a couple of weeks, consider seeing a doctor for further evaluation.