Top Causes of Swollen Toes

What are swollen toes?

If your toes are swollen, it means that fluid has built up and is trapped there.

Swollen toes can be caused by a trauma, like from something falling on your toe, or stubbing it. Swelling may also be caused by infections or from changes in the structure of your toes, such as when bunions develop. But it can also be caused by an underlying health issue like gout or heart failure.

Often, a swollen toe is easy to spot, because it’s bigger than your other toes. But if several toes are swollen, you may not notice it right away. You may have other symptoms like pain, shiny skin, joint pain, and itching.

If you had a minor trauma, swollen toes may get better with at-home treatment. But if the swelling doesn’t improve after a few days or you have other symptoms, see a doctor.

Depending on the cause of the buildup of fluid in your toes, treatment may include antibiotics, pain medication, or medications to treat any underlying conditions.

1. Trauma

Symptoms

• Pain in your foot
• Swelling of the toe
• Bruising of the toe

It can be easy to hurt your toes because the bones are fragile. Injuries can happen when something falls on your toe (crush injury) or from stubbing it. It may cause a contusion (bruise) or broken toes (fracture).

If the pain is severe and your toe looks swollen and discolored, you may need to see a doctor to make sure you haven’t broken it.

For most injuries, pain can usually be treated with over-the-counter medication, such as ibuprofen (Advil) and acetaminophen (Tylenol).

A doctor may recommend taping your injured toe to the toe next to it. This is known as buddy taping, which helps stabilize the injury. You may also want to wear solid, stable shoes that provide more support and lessen the chance of injuring the toe while it is healing. In severe cases, surgery may be needed for the injury to heal properly.

2. Skin infection

Symptoms

• Foot pain
• Foot or toe swelling
• Skin may feel warm to the touch
• Fever

An infection of the skin of the feet and toes may be fungal or bacterial and may cause swollen toes. The skin may become warm to the touch. There may be discharge from the cuticle or from an open sore and you may notice a foul odor. The skin can become very sensitive and painful.

• A fungal infection of the foot is called tinea pedis, or athlete's foot. It is caused by different types of fungi commonly found in damp places such as showers or locker room floors.
• A bacterial infection of the skin is called cellulitis. It can develop after a break in the skin allows bacteria to enter the tissue. It is frequently caused by Streptococcus or Staphylococcus bacteria.

People with diabetes can be more susceptible to skin infections of the foot. This increased risk may be related to altered immune system function or nerve and blood supply changes associated with diabetes.

Treatment of an infection involves keeping the skin clean and dry at all times. A fungal infection is treated with antifungal medications, while a bacterial infection is treated with antibiotics.

3. Bunion

Symptoms

• Pain and swelling of the big toe
• Deformity of the joint of the big toe
• Formation of corns or calluses between the first and second toe due to friction

A bunion is a painful swelling or bump at the base of the big toe. A bunion develops over time. As the big toe bends toward the other toes, it causes the bump to push out farther.

Wearing tight, narrow, and poor-fitting shoes increases the risk of getting a bunion. Arthritis may make you more likely to develop bunions. Around 23% of American adults have bunions, and they are more common in older people and in women, according to a study in the Journal of Foot and Ankle Research.

The goal of treatment is to slow or stop bunions from getting worse and to help ease any discomfort they cause. Doctors often recommend a range of approaches including supportive shoes, bunion pads, shoe inserts, ice packs, and pain medications.

Bunion pads cushion the bunion to prevent irritation from rubbing against the shoe. Placing shoe inserts in wide, flat shoes can help improve the mechanics of foot motion and decrease the amount of force on the big toe.

If your bunion causes severe pain that does not improve with these treatments or significantly limits your activities, surgery may be suggested. The recovery time from bunion surgery can be lengthy, and you may need to continue wearing more supportive shoes even after surgery.

4. Gout

Symptoms

• Intense pain
• Redness or swelling in the big toe
• Limited range of motion of your big toe
• Hard lumps underneath the skin around the joint of your toes

Gout is a form of arthritis that causes sudden pain, stiffness, and swelling in a joint. It commonly affects the big toe. In gout, uric acid crystals build up in the joint. Uric acid is made when your body breaks down certain foods and drinks, including red meat and alcohol.

Over time, flare-ups of gout can damage the cartilage and bone in your joints. Uric acid crystals can also be deposited in other parts of your body and cause problems such as kidney stones.

Your doctor may diagnose gout by examining your foot. In cases that are less clear, the diagnosis may be confirmed by aspirating (taking fluid) from the joint. There are several prescription medications that can treat gout and prevent flare-ups. Sometimes, steroid medications are injected into the toe to treat the pain.

5. Arthritis

Symptoms

• Pain, swelling, and stiffness in joints
• Warmth and redness in joints
• Deformity of joints

Several types of arthritis can cause toes to swell including rheumatoid arthritis, osteoarthritis, and psoriatic arthritis. Rheumatoid and psoriatic arthritis are both autoimmune diseases, which cause your body to attack healthy cells.

Osteoarthritis is a more common type of arthritis related to the wear and tear of your joints over time.

Treatment focuses on controlling the symptoms and inflammation with over-the-counter and prescription anti-inflammatory medications. Steroids may also be prescribed to reduce inflammation. For rheumatoid and psoriatic arthritis, prescription biologic agents may be used to target the immune system. Depending on the severity of the disease, joint injections and occasionally joint replacement surgery may be needed.

6. Heart failure

Symptoms

• Fatigue
• Chest pain
• Difficulty breathing
• Swelling of the feet and ankles
• Fainting during activity

Heart failure occurs when the function of your heart weakens. It may be related to poor blood flow to the heart, coronary artery disease, injury due to a heart attack, or uncontrolled high blood pressure.

The weakening of your heart causes it to pump blood less effectively. This can lead to fluid backing up and swelling in your legs and feet. Fluid can also back up in your lungs, causing difficulty breathing.

Heart failure is treated with medications for the underlying causes, including blood pressure medications and diuretics (which help you get rid of excess fluid from your body).

Other possible causes

A number of other conditions can cause swollen toes including:

• Venous insufficiency (problems with the valves in the veins of your legs)
• Deep venous thrombosis or DVT (a blood clot in the veins of your legs)
• Lymphedema (blockages of lymphatic fluid, involved in the function of your immune system, that can lead to swelling in the toes or leg). This is more common after removal of lymph nodes to treat cancer.
• Liver disease
• Kidney disease
• COVID-19

When to call the doctor

Because swelling in your toes can be a sign of a more serious issue, it is important to monitor your symptoms and to see a doctor for new or ongoing swelling. Call your doctor if:

• Pain doesn’t go away or gets worse
• The toe becomes numb or turns pink
• You have more bodywide symptoms such as urinary changes or weight gain

Should I go to the ER for swollen toes?

You should go to the emergency department if you have any of these signs of a more serious problem.

• Excruciating pain
• Inability to move your toe
• Redness and warmth in the toe and foot, especially if moving up the leg
• High fever
• Other concerning symptoms such as difficulty breathing

Treatment

At-home care

• Make sure your nails are well-trimmed
• If you’ve experienced trauma to your toes, rest, ice, and elevate
• Over-the-counter medications for the pain
• Wear appropriate footwear
• Monitor swelling and see a doctor if it does not get better

Additional treatment

• Diagnostic testing to determine the cause of swelling
• Prescription topical or oral medication
• Prescription medication to treat underlying issues
• Surgery