Toe pain is a common occurrence for most of us, usually caused by stubbing the toe against a hard object or with an ingrown toenail. However, there are a number of different conditions that can cause toe pain for other reasons beyond trauma. The pain may be ongoing especially with chronic conditions with episodes of acute flareups.
The toes are laden with bones, joints, muscles, tendons, ligaments, nerves and blood vessels which are covered by skin and also contains the toenails. As with any part of the body, injury or disease can affect any tissue within the toe which may lead to pain. This can be due to a range of causes. Pain is usually a sign of inflammation, the body’s response to tissue injury.
Since pain sensations are transmitted by nerves, problems with the nerves can cause toe pain even if there is no toe injury or diseases. The pain may be accompanied by other symptoms like redness, swelling, heat, reduced range of motion and alteration in sensation apart from pain. However, it is also that pain may occur on its own with no other symptoms.
Bluish discoloration of the toe, or blackish foul-smelling patches should be considered as serious signs and immediate medical attention is necessary. Delaying treatment could lead to a loss of the toe or even the spread on an infection through the bloodstream (“blood poisoning”) which can result in deadly consequences if not treated promptly.
Causes of Toe Pain
The causes of toes pain are discussed according to the mechanism of tissue injury and disease. This includes trauma, infection, inflammation, degeneration and deformities. Although toe pain can be excruciating, most people do not consider it to be a serious condition. However, pain may be the only symptom of serious and even potentially deadly conditions. It is therefore important that toes pain is assessed by a medical professional.
Injury to the toes is a common cause of toe pain. The toe is prone to injury in daily life for many reasons. It is in constant contact with the surface when walking and standing. Furthermore it is farthest away from the eye and potential insults may be visually missed. The wearing of shoes may offer some protection but it may also reduce sensation that could help detect dangers prior to injury.
- Strain and sprains are some of the more common soft tissue injuries. Strain refers to muscle and tendon injury. Ligaments that are excessively stretched, inflamed and torn are referred to as sprains.
- Dislocation also occurs with faces and arises when the articulating surfaces of the bones in a joint slips out of its normal position.
- Fractures are broken bones and usually occurs with significant force. This may also occur with stress. The extent of the fracture can vary and often there is accompanying surrounding soft tissue injury.
- Lacerations are cuts in the skin that can be caused by contact with sharp objects and severe impact. A contusion is a soft tissue injury without a break in the skin and is caused by blunt force trauma.
- Burns are tissue injuries caused by exposure to high temperature heat sources, like fire. Electrical burns are caused by contact with high current electricity.
- Detached nail occurs when force rips the toenail away from the underlying tissue (avulsion). It is usually caused by severe force.
- Frostbite is tissue injury caused by exposure to extreme cold. There are varying degrees of frostbite and in severe cases there may be death of the affected tissue.
There are number of different types of infection that can occur on the toes. This can be superficial infections of the skin and underlying tissue or deep infections of the joint or even of the bone.
- Skin infections, especially fungal infections of the skin, are common on the toes. This is known as athlete’s foot or tinea pedis but usually never spreads deeper into the toe.
- Wound infection where a break in the skin becomes infected usually with a bacteria. This can start with a superficial infection and extend deeper.
- Cellulitis is a slightly deeper infection of the tissue just underneath the skin. It can quickly progress into a sever infection if left untreated.
- Septic arthritis is inflammation of a toe join due to an infection. This often starts with a superficial infection that eventually spreads to the joint.
- Osteomyelitis is infection of the bones in the toes. It is the deepest type of infection in the toe and can be very serious. These infections can spread rapidly and usually start with superficial infections.
Non-infectious and non-traumatic inflammation occurs for various other reasons including metabolic abnormalities and autoimmune conditions, among other pathologies.
- Rheumatoid arthritis is an autoimmune condition where the immune system attacks the joint lining. The small joints like the finger and toe joints are usually affected.
- Gout is a condition where there is accumulation of uric acid and this forms into crystals within the joint that can lead to inflammation (gouty arthritis).
- Tendinitis is inflammation of the muscle tendons usually with strain and exertion. The tendons attach to the bones and transmits the force of contracting muscles to the appendages.
- Bursitis is inflammation of tiny fluid-filled pouches known as bursae (singular ~ bursa) which normally reduces friction.
Degeneration and Deformity
- Osteoarthritis is degeneration of the joint usually with age and wear-and-tear. First there is degeneration of the cartilage and then of the underlying bone.
- Bunions are bony deformities that form at the base of the toe. It usually affects the big toe. Bunions may occur with stress on the toes, like with wearing tight shoes.
- Hammertoe and mallet toe are conditions where there is abnormal bending of the toes usually by using very restrictive shoes.
- Ingrown nails are where the sharp edge of the toenail grows into the skin, compresses and pierces the soft tissue. The soft tissue becomes inflamed.
Some of the other causes of toe pain includes: