Pain in a person’s second toe is often due to injury. However, various health conditions can also cause a person to have pain in their second toe.
A person has 28 bones in their feet, 14 of which are in the toes. The bones of the feet work together with muscles, tendons, joints, and ligaments to:
- provide support
- help with balance
- help a person walk
When a person has pain in their second toe, they may find walking painful or difficult. This article will look into the various causes of second toe pain, as well as treatments and when to talk with a doctor.
A toe fracture is when a person breaks a bone in their toe. According to the American College of Foot and Ankle Surgeons, toe fractures are a common injury.
A traumatic fracture, or acute fracture, occurs due to a direct blow or impact to the area. A traumatic fracture on the second toe may be caused by dropping something heavy on it or if a person accidentally kicks something hard.
Traumatic fractures can be displaced or non-displaced. A displaced fracture means that the end of the broken bone has moved from where it should be. A non-displaced fracture means that the bone is cracked but still in alignment.
Symptoms of traumatic fracture include:
- an audible popping or cracking noise during the injury
- pain at the location of the fracture at the time of injury, which may last several hours and then go away
- crooked or abnormal toe shape
- bruising or swelling the day after the injury
A person who has experienced trauma to the foot should seek an examination from a doctor, as they may require an X-ray. Most toe fractures do not require surgery, but a small number may, particularly if there is a joint dislocation or deformity.
A sprain is an injury that affects a ligament. A ligament is a type of connective tissue that connects
- the toe becoming twisted
- overextending the toe, which means it is bent or stretched beyond its normal range
Symptoms of a sprain on the second toe include:
- not being able to use the toe
If a person thinks they have broken or sprained their toe, they should speak with a doctor. A doctor can recommend the most suitable treatment for their injury.
Treatments for fractures and sprains include:
- splinting, which is where the toe is strapped in place
- a rigid or stiff-soled shoe
- buddy taping, which is where the fractured toe is taped to the toe beside it
- putting an ice pack on the area for 20 minutes 4 to 8 times a day
- compressing the injury with bandages
- raising the foot on a pillow
- anti-inflammatory pain medications, such as ibuprofen
Capsulitis is a condition that that causes inflammation in the ligaments surrounding the joint at the base of a toe. These ligaments help the joint function properly.
Capsulitis can develop in the third and fourth toes, but it is most common in the second toe.
Capsulitis occurs when the ball of a person’s foot experiences excessive pressure. This may be caused by:
- a severe bunion deformity
- having a longer second toe than big toe
- an unstable arch
- a tight calf muscle
Symptoms of capsulitis can include:
- pain, particularly in the ball of the foot
- swelling, including at the base of the second toe
- difficulty wearing shoes
- pain when walking barefoot
A person with capsulitis may also feel as if there is something in their shoe, such as a stone or a marble.
Many conservative treatments can relieve capsulitis, including:
- resting and applying ice
- splinting or taping
- taking nonsteroidal anti-inflammatory drugs (NSAIDs)
- doing stretches recommended by a doctor
- wearing supportive shoes with stiff soles
- using orthotic devices, such as arch supports
Without treatment, capsulitis can cause the inflamed ligaments to weaken. This can lead to the second toe crossing over the top of the big toe, which is called crossover toe. Additionally, capsulitis can result in the toe becoming dislocated.
If a person develops crossover toe, they may need surgery to correct it. In cases of crossover, dislocation, and subluxation, the toes can rub against the shoes. The friction this causes may lead to corns, which may lead to breaks in the skin and infection.
Morton’s neuroma is the inflammation of the nerves between a person’s toes caused by thickened tissues surrounding the nerve. It is caused by the collapse of surrounding structures in the foot. This leads to increased traction on the nerve.
Morton’s neuroma is a result of the compression or irritation of the nerve. A common cause of Morton’s neuroma is wearing shoes that have a pointed toe box. High heels that force the toes into the toe box can also lead to Morton’s neuroma.
Other causes include:
- running or court sports
- certain foot abnormalities
Symptoms of Morton’s neuroma include:
- a feeling of something being in the shoe
- a feeling of something inside the ball of the foot
Treatment for Morton’s neuroma can include:
- arch support
- icing the area
- orthotic devices
- stopping activities that put pressure on the neuroma
- wearing shoes with a wide toe box
- injections of cortisone or local anesthetics
- surgery, if resistant to other treatments
An ingrown toenail occurs when a person’s nail curves and grows into their skin. Ingrown toenails usually affect the skin at the sides of the nail. Ingrown toenails can be a result of:
- improper trimming
- inherited causes
- improperly sized shoes
- nail problems
Ingrown toenails can cause:
Ingrown toenails can also lead to a person developing an infection in their toe.
If a person has an ingrown toenail, they should see a doctor if they have:
- nerve damage in the foot
- poor circulation
A doctor can then treat them using antibiotics or a minor surgery.
A person without infection, or a high risk medical condition, may treat their ingrown toenail at home. Home treatment for an ingrown toenail involves soaking the toe in warm water and massaging the nail fold.
Metatarsalgia is a condition that causes pain in the ball of a person’s foot. Metatarsalgia generally affects the heads of a person’s second and third metatarsals. The metatarsals are long bones that connect a person’s toes to their ankles. The head of the metatarsals make up the ball of the foot.
Metatarsalgia may be caused by:
- foot abnormalities
- high heels
- standing work
Metatarsalgia can be treated by:
- metatarsal pad insoles
- shoe wear modification
- physical therapy
Freiberg’s disease is a rare condition that generally affects a person’s second or third metatarsal. It is caused by avascular necrosis or osteonecrosis, which is when loss of blood supply leads to bones not receiving enough nourishment.
Freiberg’s disease causes the death of bone tissue due to a lack of blood.
The exact cause of Freiberg’s disease is currently unknown. However, experts believe it is due to a combination of certain genes and environmental factors.
Symptoms of Freiberg’s disease include:
- a limp
- a limited range of motion
- the sensation of walking on something hard, such as a marble
Treatment for Freiberg’s disease can depend on certain factors, such as a person’s age or its severity. Treatment can include:
- modification of activities
- crutches, casts, or shoe inserts
The plantar plate is a thick ligament that attaches the metatarsals to the first bone of the toes. Damage to the plantar plate can lead to a person developing conditions such as:
- synovitis, which is where the connective tissue of a joint becomes swollen
- toe displacement
- subluxation, which is partial dislocation of a joint
- hammertoe, which is when a person’s toe curls downward with the middle joint pointing upward
- crossover toes
- supination, which is where a person’s foot rolls outward when they walk
A doctor can treat a plantar plate injury
- stiff-soled shoes
- gradual weight bearing
- rehabilitation exercises
Occasionally, other health issues can indirectly or directly cause second toe pain, such as:
- Blisters. Ill-fitting footwear can cause blisters, a potential source of the pain.
- Arthritis. This can develop throughout the body and cause second toe pain.
- Diabetes. People with diabetes should check their feet regularly for sores and wounds, which can cause toe pain.
A person can often relieve toe pain from blisters or minor injuries by trying:
- Rest, ice, and elevation. Wrapping an ice pack in a towel and applying it to the injury for 20 minutes at a time can help reduce swelling and pain.
- Medication. NSAIDs, such as ibuprofen, can help reduce inflammation and relieve pain.
- Orthotics. Special insoles or supports can help alleviate second toe pain. These work by correcting any imbalances in the foot.
If home treatments do not cure a person’s toe pain, they should speak with a doctor. The American College of Foot and Ankle Surgeons recommends a person see a doctor if they have:
- an injury
- reduced mobility during certain activities
- discomfort when standing
- an abnormal growth
- changes in the appearance of the foot
It is important to note that people should not soak their feet in water that is too hot. People with neuropathy can develop severe burns, as they are not able to sense the heat. Soaking the feet in water that is too hot can lead to severe scalding or burning, so people should only use warm water.
There are various conditions that can cause a person to have second toe pain. These can range from injuries to certain health conditions.
Although some causes of toe pain can be treated at home, a person should speak with a doctor if they have an injury that requires medical treatment. Toe pain that is not treated can result in a person developing further complications.