Toe pain treatment in Esperance
Your toes help you balance and push off with every step, so when they’re painful, you feel it all day. Toe pain has many possible causes. The most common we see are bent toes (hammertoes, clawed toes and mallet toes), arthritis in the big toe joint, Morton’s neuroma, plantar plate tears, corns and ingrown toenails. Finding the actual cause is the key to the right treatment.
Hammertoes, clawed toes and mallet toes
These are toes that have become bent at one or more joints, so they no longer lie flat:
Hammertoe: bent upwards at the middle joint, most often the second toe
Clawed toe: bent up at the base and down at the middle and end joints, often affecting several toes
Mallet toe: bent down at the end joint, so the tip of the toe presses into the ground
Early on, bent toes are usually flexible and can be straightened by hand. Over time, they can become stiff and fixed in position.
Why they cause pain
A bent toe sticks up into the shoe or presses its tip into the ground, so it rubs and takes pressure where it isn't designed to. That leads to corns on the tops, tips, or in between the toes, callus under the ball of the foot due to extra pressure, sore joints and difficulty finding shoes that fit. It can also make your toenails thicken, make ingrown toenails worse, and lead to ulcers, especially in people with diabetes
What causes them
Tight, short or pointed shoes, or shoes with a shallow toe box
Shoes that are too big or loose-fitting as they allow your foot to slide forward, jamming your toes into the end of the toe box
Muscle imbalance in the foot, often related to foot shape
Compensatory walking styles due to issues of the back, hip, knee, ankle, or a leg length difference
Bunions, which crowd the second toe out of position
Plantar plate injury under the toe joint (read more about ball of foot pain)
Arthritis, diabetes and some nerve conditions
Family history
Big toe arthritis (hallux rigidus)
Arthritis in the big toe knuckle joint causes pain, stiffness and sometimes a bony bump on top of the joint. The toe gradually loses its ability to bend upwards, which it needs to do every time you push off to walk. Early on this is called hallux limitus (limited movement), and when the joint becomes very stiff, hallux rigidus.
You may notice:
pain and stiffness at the base of the big toe, especially when walking, running, squatting, climbing or standing on tiptoe
a bony lump on top of the joint that rubs on your shoes
swelling around the joint
walking on the outside of your foot to avoid the painful joint
It's most common from middle age, and more likely after an injury to the joint, or in people with a long or elevated first metatarsal, or a family history.
Morton's neuroma
A Morton's neuroma is a thickened, irritated nerve between two of the long bones in the foot, most often between the 3rd and 4th toes. Although the problem sits in the ball of the foot, the pain often radiates into the toes, so it's easy to mistake for a toe problem.
You may notice:
burning, tingling, numbness or shooting pain into two neighbouring toes
a feeling like walking on a pebble or a fold in your sock
pain that's worse in tight or narrow shoes and eases when you take them off and rub your foot
it may feel worse barefoot than in a shoe with a slightly raised heel
Plantar plate tear
The plantar plate is a strong ligament band under the toe knuckle joints that keeps the toes in alignment and evenly spaced. When it's overloaded or torn, two toes start to drift apart. You may also notice pain and swelling under the ball of the foot, just behind the affected toe. Read more about both conditions on our ball of foot pain page.
Other causes of toe pain
Corns and callus: hard skin on or between the toes from pressure and rubbing.
Ingrown toenails: a nail edge pressing into the skin, often with redness and swelling.
Infections: redness, swelling, warmth and often pus, usually around a toenail or in a crack, blister or wound.
Ulcers: open sores, a particular concern for people with diabetes.
Chilblains: itchy, sore, red or purple swelling on the toes in the colder months.
Injuries: stubbed or jammed toes, sprains, strains and fractures.
Gout: sudden, severe pain with a red, hot, swollen joint, most often the big toe.
Sausage toe (dactylitis): a whole toe that’s swollen, often linked to psoriatic arthritis.
Sesamoid pain: pain under the big toe joint, common in runners and dancers. Read more on our ball of foot pain page.
How we treat toe pain
Rebecca will check your toes, joints, footwear and the way you walk. Treatment depends on the cause, but often includes:
Footwear
Shoes with a deep, wide toe box give bent toes room so they don't rub or press together too much. For big toe arthritis, a stiff or rocker sole (curved under the forefoot) means the joint doesn't have to bend as much when you push off.
Toe props and protectors
Toe props: We stock a wide range of ready-made toe props. Rebecca also makes custom toe props in the clinic, moulded to your toes. They sit under bent toes to straighten and support them, taking pressure off the tips and tops. Toe props cost from $25 to $50.
Gel toe protectors: sleeves and caps that cushion corns and pressure points. We stock a range of these in the clinic.
corn care & padding
Removing painful corns and callus gives immediate relief, and padding protects the area while the other treatments work. For a neuroma or plantar plate tear, a metatarsal pad placed just behind the painful area spreads the bones and takes pressure off the nerve or ligament.
Orthotics, inserts & taping
Orthotics, inserts and taping can help when foot structure and function is contributing to bent toes, big toe joint pain, or soft tissue injury. Read more on our orthotics page.
When further help is needed
If toe pain continues despite these measures, Rebecca may refer you to your GP or a foot surgeon to discuss other options, such as injections or surgery.
When to see a podiatrist
Book in if:
you have painful corns on the tops or tips of your toes
your toes are becoming more bent or stiff
a gap is opening up between two toes, or a toe is starting to lift or drift
you’re concerned about the shape or colour of any toe
you have burning, tingling or numbness into your toes
your big toe joint is painful, stiff or has a lump on top
you're struggling to find comfortable shoes
you have diabetes and notice any rubbing, redness or broken skin on your toes
Book an appointment
If your toes are holding you back, book in with Rebecca at Esperance Podiatry. No referral is needed. Please bring the shoes you wear most often.
Call (08) 9072 1514 or visit us at Suite B, 116 Dempster Street, Esperance.