While there can be many reasons you may be experiencing shooting toe pain, two of the more common ones are peripheral neuropathy and bursitis. Here’s a quick look at both of these conditions (including their causes and how they’re treated), as well as a couple of other conditions that can lead to severe toe discomfort.
The nerves in your toes are considered “peripheral.” When these nerves suffer damage of some sort, this can result in stabbing pain or a decreased level of sensation. This is known as peripheral neuropathy, a condition that typically leads to severe discomfort as well as a lack of mobility in the affected area.
One of the main reasons for the development of peripheral neuropathy is diabetes. In fact, anywhere from 60 to 70 percent of people who have the disease will have to deal with peripheral neuropathy at one time or another. 1 But there are other causes as well, including heredity, age, arthritis, an injury to the toes, a back injury, medications, and fibromyalgia. Typical symptoms include a burning, shooting pain in the area.
If you notice any type of change in sensation in your toes, you should see a doctor as soon as you can, so he or she can determine the reason for your discomfort.
Anyone with peripheral neuropathy must check his or her feet regularly for signs of an infection or injury. The reason is that nerve damage can mask a lot of problems. If you are experiencing a decrease in sensation, you might not know if you’ve stepped on a nail or some other object that can cause damage. If you don’t inspect your feet on a regular basis, you could develop an infection that could lead to severe complications.
If your doctor suspects you have peripheral neuropathy, he or she will perform a thorough examination and probably order several types of tests as well. For example, you will probably undergo a blood test to determine the amount of sugar in the blood to see if you have diabetes.
Unfortunately, there is no cure for peripheral neuropathy. Treatment will typically focus on maintaining the overall health of your feet and to try and slow the progression of the disease. You may receive medications to help you deal with the pain, and you’ll also learn how to take care of your feet to reduce the chances of major complications occurring.
If you are diagnosed with diabetes, you’ll also learn how diet, exercise and, in some instances, medication will be given to help control your blood sugar levels. This will not only slow the progression of peripheral neuropathy, it will also benefit your general health.
The bursa is a sac filled with fluid that helps to lubricate as well as cushion joints, such as the toes. The purpose of the bursa is to reduce friction between bones, muscles, and tendons. While the bursa is designed to reduce the chances of inflammation occurring in the joints, it can sometimes become inflamed on its own. This is a condition known as bursitis.
While bursitis in the foot usually affects the area between the heel bone and the Achilles tendon, it can also affect the toes when they suffer some sort of injury. Why? Because the body often produces bursa sacs in response to damage. For example, sacs can form at the base of the big toe, as well as the bases of the second and fifth toes.
When these sacs become inflamed, shooting pain is often the result.
The symptoms of bursitis are about the same, no matter where it occurs in the body. In the toes, they include pain when touched or when running or walking, as well as redness, and a feeling of warmth. Pain usually becomes more intense when standing on your tiptoes.
Causes of Bursitis in the Toes
The feet undergo a tremendous amount of stress during the day – probably a lot more than you realize. Walking on unforgiving surfaces such as concrete or asphalt can do damage that can be made worse by ill-fitting shoes. Over time, all of these factors can lead to the formation of bursa sacs between the toes. If the stress continues to accumulate, these sacs can become inflamed as a result.
People who have a history of bursitis are at a higher risk of developing the condition again, as are people who play a lot of competitive athletics.2 If you work out frequently and fail to stretch properly before exercising, you will be at a higher risk as well.
The best way to avoid developing bursitis in your toes is to make sure your shoes not only fit correctly, but also provide you with the proper support. You need to have enough room in the front of your shoes (the area known as the “toe box”) so that your toes can wiggle at least a little bit. This will help to reduce the chances of friction building to the point that any bursa sacs that are present become inflamed. Padded socks can also lower the chances of inflammation.
Big Toe Pain
Shooting pain in your big toe joint is another painful (but common) ailment in the toes. This can be caused by various issues, including bunions or sesamoid injuries.3
Bunions are hugely common with around one-third of American women suffering from them. They appear as a deformity on the side of the big toe due to the metatarsophalangeal joint becoming larger. They most often occur from wearing tight, narrow shoes and high heels. Bunions can cause exceptional toe pain and prevent you from wearing shoes. If you have a bunion you should wear roomy shoes and protective pads to cushion the area. But if the bunion has become too large and you have difficulty wearing shoes or walking, surgery will probably be needed.
Sesamoid Injuries can be caused by a stressed tendon that holds your two tiny sesamoid bones together, near the big toe joint. This tendon is responsible for flexing the toe down. Injuries are often linked to ballet dancing, basketball, and other such jumping activities and can cause inflammation and pain in the bones and tendon. Treatment is usually based around rest, icing the area, and taping the joint.
Other Causes of Pain in the Toes
Rheumatoid Arthritis (RA)
RA affects more than a million Americans, and typically leads to severe discomfort in the toes.4It occurs when the immune system attacks the joints by mistake, leading to swelling and severe discomfort. Pain usually starts in the toes and then spreads throughout the feet and ankles.
Gout is another extremely painful condition that can affect any joint in the body. In the foot, it usually affects the big toe. Gout is caused by a buildup of uric acid crystals in a joint due to an excess of purines in the diet. Purines are chemical compounds that the body breaks down into uric acid. They are found in many types of food, but are particularly prevalent in seafood and red meat.
If you ever experience shooting pain in the toes, it will be extremely important that you see a doctor as soon as you can. The reason is that it could be a sign of a major problem that needs to be treated immediately.
Article updated: March 12, 2018
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1 Peripheral Neuropathy | Foot Health | Learn About Feet | APMA. Apmaorg. Accessed April 24, 2017.
2 Bursitis | Institute for Preventive Foothealth (IPFH). Ipfhorg. Accessed April 24, 2017.
3 Ailments of the Big Toe | American Orthopaedic Foot & Ankle Society. AOFAS.org. Web. Accessed March 13, 2018.
4 Eric Metcalf M. Does Your Foot Pain Signal a Serious Condition?. EverydayHealthcom. 2009. Accessed April 24, 2017.
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