Sharp pain in the big toe can really impact day to day activities.
Anytime we stand, walk or run, our big toe, aka "hallux", is placed under considerable force.
The big toe needs to be able to move freely and plays a vital role in balance.
Indeed around 85% of the control of the foot comes from the big toe and it bears almost twice as much weight as the other four toes combined!
Problems in either the bone of surrounding soft tissues can cause sharp pain in big toe. Toe pain may come on suddenly with and injury or gradually over time for no obvious cause.
Here we start by looking at the most common causes of sharp pain in the big toe, how they present and how to treat them. Then we go on to look at some of the less common causes of big toe pain. If your pain is also affecting the other toes, check out the toe pain article.
Sudden sharp pain in the big toe is often caused by gout, a specific type of inflammatory arthritis.
Often gout foot only affects the big toe, which is known as podagra, but it may affect the other toes as well.
Foot gout develops when high levels of uric acid form urate crystals in the big toe joint, known as Podagra.
Big toe gout may be caused by a combination of:
Symptoms of big toe gout tend to develop very suddenly and rapidly, often at night time and usually include:
Sharp pain in the big toe from gout usually lasts 5-10 days. Repeat episodes are unfortunately common, but treatment can help to not only reduce the symptoms of podagra, but also help reduce the risk of recurrence.
Treatment for big toe gout may include a combination of medication, diet and lifestyle changes - find out more in the gout treatment section.
Summary: Foot Gout is likely to be the cause of your sharp pain in big toe if you have intense pain that developed rapidly and is accompanied by redness and swelling around the big toe. Find out more in the Gout Foot section.
If your sharp pain in big toe is more underneath the toe, spreading to the foot arches, chances are the problem is Sesamoiditis.
Underneath the big toe are two small, pea-shaped bones known as the sesamoid bones which are surrounded by muscle tendons.
Inflammation of these bones and the surrounding tendons is known as sesamoiditis.
Sesamoiditis is usually caused by overloading the sesamoid bones and over working the surrounding tendons. Typical activities that cause sesamoiditis include
Sesamoiditis tends to develop gradually over time rather than suddenly and symptoms typically include:
Sesamoiditis can usually be treated successfully at home with a combination of rest, ice, medication, orthotics, taping and physical therapy. It usually takes around six weeks for the symptoms of big toe sesamoiditis to subside with these treatment methods.
Summary: Sesamoiditis is likely to be the cause if you get intermittent sharp pain in big toe that gets worse when weight-bearing and is accompanied by an underlying background ache underneath the foot. You can find out more in the Sesamoiditis section.
Turf Toe is a sprain of the soft tissues underneath the big toe.
Turf Toe is also referred to as a metatarsophalangeal joint sprain and is a common cause of sudden sharp pain in big toe in athletes.
If the big toe is suddenly forced to bend back too far, then the structures underneath the big toe are overstretched causing them to tear.
Turf Toe typically happens when pushing down through your toes with the heel lifted off the ground.
Turf Toe typically develops when:
At the time of injury, there is immediate sharp pain in the big toe which gets gradually worse over the next day or two. There may also be some swelling and bruising. The severity of the pain underneath the big toe will depend on the extent of the damage.
Treatment for Turf Toe will depend on the severity of the injury and may include a combination of rest, ice, strapping, walking cast and physical therapy - find out more in the Turf Toe Treatment section. Recovery from Turf Toe usually takes 3-4 weeks.
Summary: Turf Toe is the likely culprit if your sharp pain in big toe developed very suddenly underneath the big toe when pushing off through the toes. Find out more in the Turf Toe section
Many people who experience sharp pain in the big toe also suffer from toe lumps. There may be a small hard lump on the side of the toe, a large soft lump underneath the toe or anything in between.
Toe lumps may develop in:
When toe lumps get squashed, they often cause a sharp pain in the toe. You can find out all about the different causes, symptoms and how to treat them in the Lumps On Toes section.
We have looked at the four most common causes of sharp pain in big toe, but there are a number of other things that can cause big toe pain including:
You can find out loads more about each of these including the causes, symptoms, diagnosis and treatment in the toe joint pain section. And remember, any new onset of sharp pain in big toe should be evaluated by your doctor.
You may also be interested in the following articles:
Page Last Updated: 11/08/23
Next Review Due: 11/08/25