We can of course experience discomfort in any one of our toes, but the big toe seems to be particularly prone to pain and injury. It is the most likely to take the brunt of an impact, and also experiences more pressure and friction from our footwear. At Island Foot Clinics in Victoria, BC we see patients with a wide range of toe problems. To treat big toe pain, we first must diagnose what is causing this bothersome and sometimes even debilitating condition.

Causes and Solutions for Painful Toes

When the big toe is hurting, even due to something as common as an ingrown toenail, the pain can make it difficult to walk. When you do walk, the pressure on the toe can aggravate this pain, making it progressively worse. This is why it’s important to seek treatment as soon as possible – ignoring this or any other type of foot pain can compound your condition in a hurry.

Many types of big toe pain can be addressed with a simple, conservative treatment, while others require a more involved recovery plan. Arthritis, for example, will require a longer-term treatment strategy than would a fungal infection. Whatever the root cause might be, there is always a treatment solution that can get you comfortably back on your feet again.

Getting a Diagnosis

To find out what is causing the discomfort in your big toe, your podiatrist will examine your entire foot and, if the cause is not obvious, take an x-ray to see what is happening with the bones, joints, and cartilage. From here, we can establish a treatment plan that involves medication, physiotherapy, custom orthotics, or in some cases, surgery.

What a Treatment Plan Might Look Like

To address pain and inflammation in the big toe, your podiatrist will likely recommend an oral pain reliever and/or a cortisone injection. These will greatly reduce your discomfort but will not necessarily fix the root cause of the problem. Orthotics or custom footwear might also be recommended to create a more hospitable environment for your feet. It is particularly important to wear shoes that are wider at the tip to avoid pressure against the big toe as it heals.

As your toe is recuperating, you might benefit from either cold or hot compresses (depending on what your diagnosis is). Keeping your foot elevated when possible can also be helpful. If you are taking anti-inflammatory pain medication, your toe might be feeling better already, but that doesn’t mean it’s healed! It is still important to avoid pressure on this part of the foot and to wear your orthotics or special footwear if you will be walking or climbing stairs.

When Surgery is Recommended

There are certain conditions affecting the big toe that can be best remedied with surgery. Foot surgery has come a long way and there are now several minimally invasive procedures that can greatly improve chronic conditions such as arthritis, gout, and hammertoe. If you have bunions, which affect the base of the big toe, there is also a minimally invasive surgery that can address this painful condition.

While having a procedure of this nature requires a little more downtime, it can offer a more permanent solution to big toe pain and reduce the need for longer-term use of medications and cortisone shots, which can sometimes become less effective over time.

Simple Things You Can Do at Home

If you have recurring pain in your big toe in the absence of arthritis or another chronic condition, then the culprit is often an ingrown toenail. Some people are particularly prone to this painful condition, which can become infected if left untreated. Soaking the foot in warm water with Epsom salts a few times per day can help to speed the healing process.

Thankfully, there are two simple solutions to avoiding this type of big toe pain in the first place. The most important preventative measure is to always cut your nail straight across. Leaving your big toenail just a bit longer and having this straight edge will keep the nail from growing into the skin at the corners of the toe. Secondly, never wear shoes that are too tight. The pressure against your big toes can cause ingrown nails and other problems.

Taking a Closer Look at Big Toe Pain

As we have learned, pain in the big toe can be caused by a variety of factors. An acute injury, repetitive strain, or a systemic medical condition can all contribute to toe pain. Poor footwear and some lifestyle habits can make this problem even worse. While some types of toe pain will go away on their own, if you are still in discomfort after a week, it is definitely a good idea to see a doctor as soon as possible.

Turf Toe

Turf toe is a sprain at the base of the big toe that can cause sharp pain, swelling, and discoloration. We often see this condition in athletes who put too much repetitive stress on their toe while flexing the foot. This is typically an injury that develops gradually over time. While it can often be avoided with stretches and strength training, some people do have a genetic predisposition to this condition.

A podiatrist will usually recommend NSAIDs if the condition is mild, or a corticosteroid injection if it is more advanced. Rest, ice, compression, and elevation (and a little patience!) are typically enough to resolve this issue. If there is significant joint instability or the cartilage has been damaged, surgery might be recommended.


The joint in the big toe can be particularly prone to arthritis. Also known as hallux rigidus, this painful condition can cause swelling and stiffness, making it quite difficult to walk or even stand for extended periods.

In addition to NSAIDs and corticosteroid shots, wearing custom footwear with shock-retardant insoles can greatly increase comfort. Physical therapy is also a good idea. If arthritis become severe, surgical fusion of the big toe is a possible option.  


Sesamoiditis is an inflammatory disorder that affects the two bones located under the big toe joint. The tendons and surrounding tissues can also be affected, greatly reducing toe mobility.  This is typically an overuse injury that can benefit from the use of an orthotic device.


Gout is an arthritic-like condition that commonly affects the big toe joint. It can be brought on by a poor diet and by certain chronic medical conditions such as diabetes or hypertension. Intense pain, swelling, and inflammation around the big toe joint can make this condition very debilitating.

There are certain prescription medications and dietary changes that can be helpful. For example, eating more vegetables, whole grains, and fiber, and less red meat, sugar, and alcohol, can make a big difference.  

Sprained Toe

If you have an injured ligament in the toe, the pain can radiate to other parts of the foot. Ignoring a sprain can make it much worse, so seeking medical help is a must. If you’ve suffered from an acute injury, it’s also possible that the toe could be broken, so your doctor may order a scan.

Resting as much as possible and using crutches when you need to move around is key. Any pressure on your foot can cause a setback. You may also require a toe splint or taping to keep the toe immobile as it heals.

Finding the Best Foot Care in Victoria, BC

There is no reason to live with foot or toe pain. Locating a skilled podiatrist in your area is the first step in finding a solution for your discomfort. Contact us today at Island Foot Clinics in Victoria, BC to book your consultation and find out more about the treatments we offer. We also have clinics in Prince George, Kelowna, Nanaimo, Campbell River, Terrace, and Williams Lake.