11 Foot Pressure Points and Corresponding Benefits

Pain in your big toe joint can be due to a sudden injury like the sports-related "turf toe." Chronic health conditions like arthritis, bursitis, bunions, gout, and lesser-known conditions like sesamoiditis can also cause pain, joint stiffness, swelling, and a grinding sensation.

The first metatarsophalangeal joint is the joint that connects the big toe to your foot's first metatarsal bone. It plays a key role in supporting body weight and how your foot works. Treatment will vary based on the cause, so see a healthcare provider for big toe pain that persists or worsens.

causes of pain in the big toe joint

Illustration by Emily Roberts for Verywell Health

Arthritis

The most common form of arthritis that affects the big toe joint is osteoarthritis. This is caused by a breakdown of the tissues that cover the ends of bones where they meet at the joint.

Osteoarthritis of the first metatarsophalangeal joint is described as:

  • Hallux limitus, which occurs when the joint movement is limited.
  • Hallux rigidus, which happens when the joint becomes unusually stiff. This makes it harder to straighten the big toe.

Osteoarthritis may develop from problems with foot structure or movement, resulting in excess wear and tear of the cartilage. This causes pain from the bone-on-bone rubbing when you move.

Trauma, such as a big toe fracture or dislocation, can also result in osteoarthritis. Other less common types of arthritis that affect the big toe include rheumatoid arthritis, gouty arthritis, and psoriatic arthritis.

Symptoms of arthritis in the big toe include:

  • Pain that's usually most noticeable when standing and walking
  • Swelling
  • A bump on the top of the foot
  • Redness at the site of discomfort
  • Stiffness and limited mobility in the big toe

Sometimes, walking can be painful, and people may develop an antalgic gait, which is an abnormal pattern of walking, to compensate. This can eventually lead to ankle, knee, hip, or lower back pain. Knobby growths called bone spurs also may develop on the top of the big toe or the foot.

Treatment Options

Your healthcare provider can recommend treatments that include:

  • An anti-inflammatory pain reliever like Advil (ibuprofen) to ease arthritic pain
  • A steroid shot into the joint can sometimes reduce pain and inflammation.
  • Wearing shoes with a stiff sole or shoes that bend at the big toe joint. Custom foot orthotics with a modification called Morton's extension can help when motion causes pain.
  • Physical therapy to improve mobility

Surgery may be needed to remove the bone spurs. A cheilectomy is a bone fusion of the joint. Other procedures that might be indicated include Cartiva® implants to replace cartilage, joint replacement or removal surgery, or arthrodesis (a type of bone fusion).

Bunion

A bunion is a large, knobby bump over the big toe joint. Factors that contribute to bunions:

A bunion usually causes a hallux valgus deformity, a deviation of the big toe towards the pinky toe.

The bunion can become more prominent towards the midline of your body, making it more painful in closed-toe shoes. Over time, the big toe drifts more towards the pinky toe, pushing and dislocating all the other toes.

The usual result is a widened forefoot and a red, irritated, and sometimes swollen bump on the side of the big toe joint.

Bunions develop due to displacement of the big toe joint. Sometimes extra bone growth develops from the dislocation or arthritis develops in that joint.

Treatment Options

There are things you can do to ease bunion symptoms.

Here are a few strategies to consider:

  • Wear flat, stretchable shoes with a wide toe box to allow extra space around the big toe. This will reduce pressure on the bunion.
  • Place a pad over the bunion to prevent rubbing and irritation.
  • Stretch to improve joint mobility.
  • After exercising while on your feet, apply a cold pack over the bunion (put a paper towel or cloth between the pack and your skin).
  • If your bunion is painful or swollen, talk to your doctor about taking an anti-inflammatory like Advil (ibuprofen).

If your discomfort persists despite these simple measures, a podiatrist (a doctor specializing in foot conditions) can fit you with special shoe inserts called orthotics to support your big toe. They may also provide you with toe splints you wear at night to realign the big toe while you sleep. 

If these measures do not work and you still have bunion pain or difficulty walking, consider a surgical procedure that can be done to reposition the bone and remove the bump. 

Find the Right Shoe Store

If your feet are aching, there's a good chance your shoes could be to blame—especially if you spend a lot of time on your feet. Wearing properly fitted shoes can help prevent pain and injuries in your feet. You may benefit from going to a shoe store where they can examine the shape of your feet and how you walk—then fit your foot in a shoe that properly supports your foot. Running shoe shops are an excellent place to start (even if you're not a runner).

Ingrown Toenail

An ingrown toenail often affects the big toe, causing pain as well as:

  • Inflammation of the affected skin
  • Swelling and fluid at the site
  • Overgrown skin around the nail
  • White or yellow pus and, sometimes, bleeding

An ingrown toenail is more likely if you have sweaty feet, aren't careful about clipping nails, or wear tight socks and shoes. It can occur due to the natural shape of your toenail, though, as well as if you have a stubbed big toe or other injury. People diagnosed with diabetes are at higher risk, too.

Treatment

Surgery may be needed to treat an ingrown toenail that is infected. This may involve partial or full removal of the affected nail. Prevention is key to avoiding complications. These steps include:

  • Wearing shoes that fit properly
  • Washing your feet every day
  • Removing dead skin from your feet (a pumice stone can work)
  • Cutting your nails straight across rather than on an angle

Extensor Tendonitis

Tendonitis (sometimes spelled tendinitis) is the inflammation of a band of connective tissue that connects muscles to bone, called a tendon.

The type that can affect the big toe is called extensor tendonitis, caused by inflammation of the extensor tendon that helps you lift your toes or straighten your fingers. Extensor tendonitis of the foot is sometimes referred to as metatarsal tendonitis.

Extensor tendinitis of this sort is usually caused by repetitive stress on the ball of the foot and toes. Sports that involve sprinting or dorsiflexion (bending backward) of the toes, such as long-distance running or gymnastics, can cause this.

Wearing high heels, tight shoes, or poorly fitted shoes can also increase the risk.

Treatment Options

Extensor tendinitis is usually treated conservatively with rest, ice application, and nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil. Gentle stretching can keep the tendons and joints from getting stiff.

If inflammation is severe, your healthcare provider may recommend immobilization of the foot with a special steel-soled boot with a rocker bottom. Steroid injections are not recommended as they can weaken tendons and cause them to burst.

In severe cases, a surgery called a tendon transfer may be used to harvest a piece of tendon from another part of the foot, which is used to bridge the gap where the damaged tendon is removed.

Capsulitis

Capsulitis is a condition that most commonly affects the second toe, but it causes that toe to move toward the big toe. In later stages of untreated capsulitis, it may even cross over the big toe.

Capsulitis, also called predislocation syndrome, is an inflammation of the ligaments that form a capsule at the base of the second toe and allow it to function. It can affect the third and fourth toes, too, causing pain, swelling, and discomfort that can make walking difficult.

It's thought that excessive weightbearing on the ball of the foot, beneath the joint, leads to the inflammation. Capsulitis may be more common in people with bunions, a second toe that's longer than the first, or with atypical calf muscles and foot arches.

Treatment

Treatment for capsulitis can include

  • Rest, ice, and splinting of the toe
  • Medication
  • Orthotics and shoes for support
  • Stretching for people with tight calf muscles

Once the second toe starts to drift toward the big toe, surgery is needed to return it to a normal position. Without intervention, "crossover toe" will affect the big toe.

Toe Sprain

A sprain involves the overstretching and tearing of a connective band of tissue, called a ligament, that connects bone to bone.

In the big toe, the ligaments prone to a sprain are called collateral ligaments. These run along both sides of the big toe and prevent the big toe from moving too far from side to side.

Injury can occur during sports or by simply tripping and falling at home. Big toe sprains can be caused by:

  • Stubbing your toe badly
  • Jamming your toe when landing awkwardly
  • Falling in a position that causes your big toe to twist

A sprain is not the same thing as a strain, which involves an overstretched muscle rather than a ligament.

While a strain is a less common cause of big toe pain, it is possible to sustain an injury at the tail end of the extensor hallucis longus muscle which runs from the shin bone and aids with dorsiflexion of the big toe.

Treatment Options

The treatment of a toe sprain is almost invariably conservative, using a system called the RICE method, which involves:

  • Rest ("R")
  • Ice application ("I")
  • Compression of the toe with bandages to reduce swelling ("C")
  • Elevation of the foot to reduce swelling and pain ("E")

Over-the-counter NSAIDs can also help. Severe strains may require immobilization of the foot for seven days or more.

Toe Bursitis

Bursitis is the inflammation of a cushioning sac between joints, called the bursa, caused mainly by repetitive stress on the joint. Bursitis may occur with inflammatory conditions like rheumatoid arthritis and infections like cellulitis (where a local skin infection has spread to deeper tissues).

Bursitis of the foot and toes is mostly seen with:

  • Runners or sports that involve jumping (like basketball)
  • Foot malformations like Haglund's deformity
  • Wearing high heels or tight shoes

Bursitis can cause pain, redness, swelling, and stiffness that is sometimes indistinguishable from tendonitis.

Treatment Options

Bursitis of the foot is typically treated with rest, ice application, and NSAIDs. Shoe inserts or custom orthotics can help correct imbalances in the foot and help ease pressure on the toe. Severe cases may treated with a cortisone shot, but this is used with caution to avoid tendon damage.

If all other treatments fail, surgery may be pursued. This typically involves a bursectomy in which the bursa is surgically removed, allowing a new one to grow in its place.

Toe Fracture

The big toe is made up of two bones called the distal and proximal phalanx (plural is phalanges). The distal phalanx is the middle bone situated next to the metatarsophalangeal joint. The proximal phalanx is the larger bone at the end of the toe.

A fracture of the distal or proximal phalanx can:

  • Cause a closed fracture in which the skin is unbroken. This can occur when something hard is dropped on the toe or after a high-impact blow, such as kicking a wall.
  • Cause a stress fracture (hairline fracture) if you fall and twist the bone
  • Rarely, lead to an open fracture in which the skin is broken. This can be caused by contact sports or an automobile accident. Around 16% of all toe fractures occur during sports.

Toe fractures can happen to anyone, but factors like older age, osteoporosis (porous bones), and the heavy use of corticosteroid (steroid) drugs can increase the risk.

Treatment Options

Depending on the severity of the break, a toe fracture may involve immobilization with a cast, walking boot, taping, or a stiff-bottomed shoe commonly used after foot surgery. Crutches can help you move while healing. Rest, ice application, and over-the-counter pain relievers like Tylenol (acetaminophen) can also help.

If the fracture is severe, it may first need to be reduced. This is when the broken bones are manually put into the correct position before casting or immobilization. Compound fractures may need surgery, using pins, plates, and screws to hold the bone fragments together.

Expect recovery to take anywhere from six to eight weeks, maybe more.

Gout

Gout can affect the big toe joint. Gout occurs when uric acid builds up in the blood, forming crystals that get deposited into a joint—commonly the big toe joint. The medical term describing gout in the big toe joint is "podagra."

Symptoms of gouty arthritis include a swollen, red, hot, and intensely painful joint. Severe joint damage may occur if gout attacks go untreated and occur repeatedly for several years. In addition, gout tophi may form, which are visible deposits of uric acid on the toe. 

Uric acid is a waste product in your blood that your body makes after it breaks down purines, which are substances found in some foods. If your kidneys cannot remove the uric acid properly, urate crystals can form and lead to gout.

Gouty arthritis can resemble an infected joint, so your doctor may order a blood test to check your uric acid levels. If they're elevated, this can be a clue that a gout attack is occurring.

Doctors often need to take a sample of the fluid in the joint to test it for uric acid crystals and make a diagnosis.

Treatment Options

Treatment for gout in the big toe joint entails treating both the toe and the high blood uric acid levels.

For the toe, an acute gout attack can be treated with oral medication, including colchicine, an anti-inflammatory, or steroids. Sometimes, a corticosteroid injection into the painful joint can help relieve symptoms.

To ease gout and prevent future attacks, your doctor will likely recommend losing weight if you are overweight and suggest a gout diet. Changes include:

  • Cutting back on red meat, seafood, and alcohol
  • Avoiding foods and drinks with high-fructose corn syrup
  • Adding low-fat dairy, vegetables, and whole-grain foods into your diet

If you have multiple gouty attacks, your doctor may prescribe a medication that lowers uric acid levels in the bloodstream. Sometimes, surgery can correct gouty arthritis damage.

Sesamoiditis

The sesamoid bones of the foot are two tiny bones located under the first metatarsal bone. They are part of the big toe joint. They sit within a tendon that flexes the big toe down.

The sesamoid bones are prone to pain and inflammation (sesamoiditis) when there is acute or chronic trauma. Sesamoiditis is often linked to activities that involve balancing on toes or jumping, such as ballet dancing or basketball.

Fracturing the sesamoid bone can cause similar symptoms, often with significant pain under the ball of the foot and the big toe joint.

Treatment Options

Sesamoiditis can be challenging to treat because the ball of the foot has to bear a lot of body weight when you walk.

Sesamoiditis due to inflammation may be treated with:

  • Rest and elevation to limit pressure
  • Padding around the ball of the foot
  • Shoe orthotics (arch supports) to take pressure off the ball of the foot.
  • Custom orthotics, with embedded padding to relieve pressure

Your doctor or physical therapist may recommend wearing hard-soled or rocker-bottom shoes. A rocker-bottom shoe has a curved sole, relieving pressure from the bottom of the toes.

In severe cases, or when the sesamoid bone is fractured, you may need to take weight off the bone by using crutches or wearing a cast. Some sesamoid fractures may require surgery.

Turf Toe

Turf toe is a common sports-related injury. It creates pain in the bottom of the big toe joint. The pain stems from a sprain or tears to a ligament in the toe.

Turf toe is often seen in athletes who play sports on artificial turf, like football and soccer. The injury occurs when the toe endures intense force while flexing, such as when an athlete pushes off from the big toe when running. 

The conditions of the hard turf, athletic shoes, and stress on the toe from running may all contribute to this injury. Depending on the severity of the injury, symptoms can include swelling, discoloration, and pain.

Treatment Options

Treatment for turf toe entails resting the big toe joint and allowing it to heal. Custom orthotics with Morton's extension can reduce motion.

You may need to ice, elevate, and possibly use crutches for an acute strain. For more severe injuries, you may need to be referred to a foot surgeon.

Summary

Pain in your big toe joint can be caused by injuries, problems with how your foot moves, or diseases like osteoarthritis and gout. It is also associated with conditions like tendonitis, bursitis, sprains, strains, and fractures.

Treatment depends on the cause of your big toe joint pain. Sometimes, your big toe joint may heal with rest, ice, and sometimes crutches. For severe cases, you may need surgery.

24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Azab AR, Elnaggar RK, Aly SM, Basalem N, Alamri AM, Saleh AK, et al. From injury to rehabilitation: How kinesiology taping helps patients with first metatarsophalangeal joint sprain (turf toe) in pain reduction, gait parameters and functional ability improvement. A randomized clinical trial. Heliyon. 2024 Apr 16;10(8):e29746. doi: 10.1016/j.heliyon.2024.e29746

  2. Roddy E, Menz HB. Foot osteoarthritis: latest evidence and developments. Ther Adv Musculoskelet Dis. 2018 Jan;10(4):91-103. doi:10.1177/1759720X17753337

  3. American Academy of Orthopaedic Surgeons. Hallux Rigidus (Stiff Big Toe).

  4. Penn Medicine. Foot and Ankle Arthritis Treatment Options.

  5. Fletcher AN, Patel V, Cerrato R. Minimally Invasive Cheilectomy for Hallux Rigidus. Foot Ankle Clin. 2024 Sep;29(3):471-484. doi: 10.1016/j.fcl.2024.01.003

  6. Alkhalifah KM, Almotiri MM, Alharbi AE, et al. A systematic review and meta-analysis of the prevalence of hallux valgus in the general population. Cureus. 2023:15(7):e42739. doi:10.7759/cureus.42739

  7. Lewis LK, Chen J, Johnson CS, Adams SB Jr. Hallux Valgus Bunion Splint: Surgical Dressing Technique. Foot Ankle Spec. 2024 Feb;17(1_suppl):53S-56S. doi:10.1177/19386400231169376

  8. Aebischer AS, Duff S. Bunions: A review of management. Aust J Gen Pract. 2020;49(11):720-723. doi:10.31128/AJGP-07-20-5541

  9. National Health Service. Ingrown Toenail.

  10. Scott A, Backman LJ, Speed C. Tendinopathy: update on pathophysiologyJ Orthop Sports Phys Ther. 2015;45(11):833-841. doi:10.2519/jospt.2015.5884

  11. Coady-Fariborzian L, Mueller B. Application of hand therapy extensor tendon protocol to toe extensor tendon rehabilitation. Fed Pract. 2020 Jan;37(1):33–37.

  12. Hospital for Special Surgery. Tendonitis/tendinitis.

  13. American College of Foot and Ankle Surgeons. Capsulitis of the Second Toe.

  14. MedlinePlus. Sprains and strains.

  15. Ab-Rahman S, Sulaiman AR, Muzaffar T. Irreducible dorsal dislocation of the interphalangeal joint of the big toe: a case report. Trauma Case Rep. 2016 Apr;3:32–35. doi:10.1016/j.tcr.2016.05.004

  16. American Podiatric Medical Association. What is bursitis?

  17. Mitchell JJ, Chahla J, Vap AR, et al. Endoscopic trochanteric bursectomy and iliotibial band release for persistent trochanteric bursitisArthrosc Tech. 2016;5(5):e1185-e1189. doi:10.1016/j.eats.2016.07.005

  18. Robertson GAJ, Sinha A, Hodkinson T, Koc T. Return to sport following toe phalanx fractures: a systematic review. World J Ortho. 2023 Jun 18;14(6):471–484. doi:10.5312/wjo.v14.i6.471

  19. Moura SP, Meulendijks MZ. Veeramani A, et al. Epidemiology and fracture patterns of traumatic phalangeal fractures. Plast Reconstr Surg Glob Open. 2022 Aug;10(8):e4455. doi:10.1097/GOX.0000000000004455

  20. Bernal JA, García-Campos J, Marco-LLedó J, Andrés M. Gouty Involvement of Foot and Ankle: Beyond Flares. Reumatol Clin (Engl Ed). 2021 Feb;17(2):106-112. English, Spanish. doi:10.1016/j.reuma.2019.12.003

  21. FitzGerald JD, Dalbeth N, Mikuls T, Brignardello-Petersen R, Guyatt G, Abeles AM, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res (Hoboken). 2020 Jun;72(6):744-760. doi:10.1002/acr.24180

  22. Kaur P, Carroll MR, Stewart S. The assessment and management of sesamoiditis: a focus group study of podiatrists in Aotearoa New Zealand. J Foot Ankle Res. 2023 May 16;16(1):29. doi:10.1186/s13047-023-00628-w

  23. Limaye N, Sethi M, Ayyaswamy B. Outcomes of Surgical Management of Turf Toe: 12-Year Results. Cureus. 2024 Apr 8;16(4):e57808. doi: 10.7759/cureus.57808

  24. Seow D, Tengku Yusof TNB, Yasui Y, Shimozono Y, Kennedy JG. Treatment options for turf toe: a systematic review. J Foot Ankle Surg. 2020;59(1):112-116. doi:10.1053/j.jfas.2018.12.041

Catherine Moyer

By Catherine Moyer, DPM
Catherine Moyer, DPM, is a podiatrist experienced in the diagnosis, treatment, and prevention of disorders of the foot and ankle.