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    Toe, Foot, and Ankle Problems, Noninjury

    Toe, Foot, and Ankle Problems, Noninjury

    Topic Overview

    Illustration of the bones of the foot Everyone has had a minor problem with a toe, foot, or ankle. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear or overuse. Toe, foot, or ankle problems can also occur from injuries or the natural process of aging.

    Your toes, feet, or ankles may burn, sting, hurt, feel tired, sore, stiff, numb, tingly, hot, or cold. You may have had a "charley horse" (muscle cramp) in your foot while lying in bed at night. Your feet or ankles may change color or swell. You may have noticed an embarrassing odor from your feet. Some changes in your feet and ankles are normal as a person ages or during pregnancy. Home treatment is usually all that is needed to relieve your symptoms.

    Toe, foot, or ankle problems may be caused by an injury. If you think an injury caused your problem, see the topic Toe, Foot, or Ankle Injuries. But there are many noninjury causes of toe, foot, or ankle problems.

    Skin problems

    Most skin problems that affect your feet are more annoying than they are serious. If you have:

    • The feeling of walking on pebbles: You may have plantar warts on the bottom of your feet.
    • Patches of thick and tough skin on the heel or ball of your foot: You may have a callus, corn, blister, or skin growth.
    • Red, peeling, cracking, burning, and itchy skin between your toes or on the bottom of your feet: You may have athlete's foot. Or maybe your feet are reacting to the shoes you are wearing ( shoe dermatitis ).
    • Red, swollen, and painful skin around a toenail: You may have an ingrown nail or an infection around your nail ( paronychia ).
    • Red, swollen soles of your feet that are painful to the touch or when you walk: You may have a bacterial infection. Public showers, hot tubs, or swimming pools are common areas where bacterial infections, athlete's foot, and warts can be spread to your feet.

    Joint problems

    Toe joints are more likely to develop problems than other joints in your feet.

    • Heat, pain, redness, swelling, and extreme tenderness that comes on quickly in your big toe joint may be caused by gout . Similar symptoms can occur with an infection.
    • If you have swelling or a bump at the base of your big toe, you may have a bunion .
    • If you have a bump on the outside of your little toe, you may have a bunionette , also called a Tailor's bunion.
    • If your toes, other than your big toes, bend in an odd position, you may have hammer toes, mallet toes, or claw toes .
    • Joint pain, stiffness, and swelling are common when you have conditions such as bursitis , arthritis , lupus , or gout.

    Pain

    You may develop pain in the front (ball) of your foot (metatarsalgia) or in your heel. Heel problems commonly occur when you overuse calf muscles, wear shoes with high heels, or participate in activities, such as running, that cause repeated pounding on your heels.

    Numbness or tingling

    Many conditions may affect the nerves of the foot and cause numbness, tingling, and burning.

    • Pain, burning, tingling, or numbness that occurs between your toes, especially the third and fourth toes, and in the ball of your foot may be caused by a growth around the nerves (Morton's neuroma).
    • Pain, numbness, and tingling that begins in your back or buttock, moves down your leg, and into your foot may be sciatica , caused by a pinched nerve (nerve root compression).
    • Foot and ankle pain that occurs with numbness and weakness in your foot may be caused by a pinched nerve in your ankle ( tarsal tunnel syndrome ) or back (sciatica).
    • Burning, numbness, or lack of feeling in your feet may be caused by poor circulation, especially in people who have diabetes or peripheral arterial disease . The circulation problem can lead to nerve damage (peripheral neuropathies). Foot problems are more likely to develop in people who have these conditions.

    Check your symptoms to decide if and when you should see a doctor.

    Check Your Symptoms

    Do you have a toe, foot, or ankle problem?
    This includes symptoms like pain and changes in the way your feet look or feel.
    Yes
    Toe, foot, or ankle problem
    No
    Toe, foot, or ankle problem
    How old are you?
    Less than 5 years
    Less than 5 years
    5 years or older
    5 years or older
    Are you male or female?
    Male
    Male
    Female
    Female
    Did you injure the toe, foot, or ankle in the past month?
    Yes
    Toe, foot, or ankle injury in the past month
    No
    Toe, foot, or ankle injury in the past month
    Have you had toe, foot, or ankle surgery in the past month?
    If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.
    Yes
    Toe, foot, or ankle surgery in the past month
    No
    Toe, foot, or ankle surgery in the past month
    Do you have a problem with your nails?
    This means a problem that affects the nails only and not any other part of the limb (no other parts of the finger or hand or of the toe or foot).
    Yes
    Nail problem
    No
    Nail problem
    Has sudden, severe weakness or severe numbness affected the whole leg or the whole foot?
    Weakness is being unable to use the leg or foot normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same thing as weakness.
    Yes
    Severe or sudden numbness or weakness in the whole leg or foot
    No
    Severe or sudden numbness or weakness in the whole leg or foot
    When did it start?
    Think about when you first noticed the weakness or numbness or when you first noticed a major change in the symptoms.
    Less than 4 hours ago
    Numbness or weakness began less than 4 hours ago
    From 4 hours to 2 days (48 hours) ago
    Numbness or weakness began from 4 to less than 48 hours ago
    From 2 days to 2 weeks ago
    Numbness or weakness began 2 days to 2 weeks ago
    More than 2 weeks ago
    Numbness or weakness began more than 2 weeks ago
    Do you still have any weakness or numbness?
    Weakness or numbness that does not go away may be more serious.
    Yes
    Numbness or weakness is now present
    No
    Numbness or weakness is now present
    Has the weakness or numbness:
    Gotten worse?
    Numbness or weakness is getting worse
    Stayed about the same (not better or worse)?
    Numbness or weakness is unchanged
    Gotten better?
    Numbness or weakness is improving
    Is the foot or are any of the toes blue, very pale, or cold and different from the other foot or toes?
    If the foot or leg is in a cast, splint, or brace, follow the instructions you got about how to loosen it.
    Yes
    Foot or toes are blue, very pale, or cold and different from other foot or toes
    No
    Foot or toes are blue, very pale, or cold and different from other foot or toes
    Is there any pain in the toes, foot, or ankle?
    Yes
    Pain in toes, foot, or ankle
    No
    Pain in toes, foot, or ankle
    How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
    5 to 10: Moderate to severe pain
    Moderate to severe pain
    1 to 4: Mild pain
    Mild pain
    Has the pain:
    Gotten worse?
    Pain is increasing
    Stayed about the same (not better or worse)?
    Pain is unchanged
    Gotten better?
    Pain is improving
    Is there a new limp?
    Yes
    New limp
    No
    New limp
    Do you have any pain in your toes, foot, or ankle?
    Yes
    Toe, foot, or ankle pain
    No
    Toe, foot, or ankle pain
    How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
    8 to 10: Severe pain
    Severe pain
    5 to 7: Moderate pain
    Moderate pain
    1 to 4: Mild pain
    Mild pain
    How long has the pain lasted?
    Less than 2 full days (48 hours)
    Pain less than 2 days
    2 days to 2 weeks
    Pain 2 days to 2 weeks
    More than 2 weeks
    Pain more than 2 weeks
    Has the pain:
    Gotten worse?
    Pain is getting worse
    Stayed about the same (not better or worse)?
    Pain is unchanged
    Gotten better?
    Pain is getting better
    Do you think the problem may be causing a fever?
    Some bone and joint problems can cause a fever.
    Yes
    Possible fever
    No
    Possible fever
    Are there any symptoms of infection?
    Yes
    Symptoms of infection
    No
    Symptoms of infection
    Are there red streaks leading away from the area or pus draining from it?
    Yes
    Red streaks or pus
    No
    Red streaks or pus
    Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
    "Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
    Yes
    Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
    No
    Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
    Are you having trouble moving the foot or toes?
    Pain and swelling can limit movement.
    Yes
    Difficulty moving foot or toes
    No
    Difficulty moving foot or toes
    Is it very hard to move or somewhat hard to move?
    "Very hard" means you can't move it at all in any direction without causing severe pain. "Somewhat hard" means you can move it at least a little, though you may have some pain when you do it.
    Very hard
    Very hard to move
    Somewhat hard
    Somewhat hard to move
    How long have you had trouble moving the foot or toes?
    Less than 2 days
    Difficulty moving foot for less than 2 days
    2 days to 2 weeks
    Difficulty moving foot for 2 days to 2 weeks
    More than 2 weeks
    Difficulty moving foot for more than 2 weeks
    Has the loss of movement been:
    Getting worse?
    Difficulty moving is getting worse
    Staying about the same (not better or worse)?
    Difficulty moving is unchanged
    Getting better?
    Difficulty moving is improving
    Is there any swelling?
    Yes
    Swelling
    No
    Swelling
    Do you have any new shortness of breath or chest pain?
    When this occurs with swelling or deep pain in one leg, it can be a symptom of a blood clot that has moved from the leg to the lung.
    Yes
    Shortness of breath or chest pain
    No
    Shortness of breath or chest pain
    Have you been urinating a lot less than usual lately?
    Yes
    Decreased urination
    No
    Decreased urination
    Is the swelling quickly getting worse (over hours or days)?
    Yes
    Swelling is quickly getting worse
    No
    Swelling is quickly getting worse
    Is there a painful lump, bump, growth, or thickened area on the foot or toe?
    Yes
    Painful lump, bump, thickening, or growth on toe or foot
    No
    Painful lump, bump, thickening, or growth on toe or foot
    Have you had toe, foot, or ankle problems for more than 2 weeks?
    Yes
    Symptoms for more than 2 weeks
    No
    Symptoms for more than 2 weeks

    Pain in children under 3 years

    It can be hard to tell how much pain a baby or toddler is in.

    • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
    • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
    • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

    When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

    There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

    Try Home Treatment

    You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

    • Try home treatment to relieve the symptoms.
    • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

    Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

    • Your age. Babies and older adults tend to get sicker quicker.
    • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
    • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
    • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
    • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

    Pain in children 3 years and older

    • Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
    • Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
    • Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

    Seek Care Now

    Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

    • Call your doctor now to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don't have one, seek care in the next hour.
    • You do not need to call an ambulance unless:
      • You cannot travel safely either by driving yourself or by having someone else drive you.
      • You are in an area where heavy traffic or other problems may slow you down.

    Symptoms of infection may include:

    • Increased pain, swelling, warmth, or redness in or around the area.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.

    Pain in adults and older children

    • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
    • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
    • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

    Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

    • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
    • Long-term alcohol and drug problems.
    • Steroid medicines, which may be used to treat a variety of conditions.
    • Chemotherapy and radiation therapy for cancer.
    • Other medicines used to treat autoimmune disease.
    • Medicines taken after organ transplant.
    • Not having a spleen.

    Call 911 Now

    Based on your answers, you need emergency care.

    Call 911 or other emergency services now.

    Make an Appointment

    Based on your answers, the problem may not improve without medical care.

    • Make an appointment to see your doctor in the next 1 to 2 weeks.
    • If appropriate, try home treatment while you are waiting for the appointment.
    • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

    Seek Care Today

    Based on your answers, you may need care soon. The problem probably will not get better without medical care.

    • Call your doctor today to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don't have one, seek care today.
    • If it is evening, watch the symptoms and seek care in the morning.
    • If the symptoms get worse, seek care sooner.
    Toe, Foot, and Ankle Injuries
    Postoperative Problems
    Nail Problems and Injuries

    Home Treatment

    Most minor toe, foot, or ankle problems go away on their own. Home treatment is usually all that is needed to relieve your pain, swelling, and stiffness.

    • If you have swelling, be sure to remove all rings , anklets, or any other jewelry that goes around your leg or ankle. It will be harder to remove your jewelry if swelling increases, which in turn can cause other serious problems, such as nerve compression or restricted blood flow.
    • Use rest, ice, compression, and elevation (RICE) for pain and swelling.
    • Stop, change, or take a break from any activities that cause your symptoms.
      • Avoid "running through the pain," which may increase damage to your foot.
      • Consider changing your exercise routine if you think running or another high-impact sport is causing your foot pain. Switch temporarily to a low-impact exercise activity, such as cross-country skiing, stair-climbing machines, bicycling (regular or stationary), rowing, or swimming.
      • Use sensible sports training techniques, such as wearing the right shoes and stretching before activities.
    • Gently massage your feet to reduce discomfort, relax your feet, and promote circulation.
    • Wear comfortable and supportive shoes and socks. See tips on good footwear to learn how to choose the right shoes for you.
    • Consider using an orthotic shoe device, such as an arch support, to help relieve your foot pain.
    • Try heel-cord exercises to increase your strength and flexibility if your heel or heel cord (Achilles tendon) is tight and painful. This may help relieve your heel pain.
    Medicine you can buy without a prescription
    Try a nonprescription medicine to help treat your pain:

    Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

    Safety tips
    Be sure to follow these safety tips when you use a nonprescription medicine:
    • Carefully read and follow all directions on the medicine bottle and box.
    • Do not take more than the recommended dose.
    • Do not take a medicine if you have had an allergic reaction to it in the past.
    • If you have been told to avoid a medicine, call your doctor before you take it.
    • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
    • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

    Try home treatment for these other foot problems such as:

    • Foot cramps. Try the following home treatment to help relieve leg cramps:
      • Straighten your leg.
      • Hold your foot and pull it toward you. It is probably easiest to do this from a sitting position. You can loop a towel around the end of your foot and pull it toward you if you have trouble reaching your foot.
      • Gently rub or massage your foot.
    • Calluses and corns . Home treatment may help relieve discomfort from corns, calluses, or other thickened skin:
      • To thin a corn or callus, rub the thickened skin with a towel after a shower or bath.
      • Use a pumice stone after bathing to reduce the tissue. Do not do this if you have diabetes, peripheral arterial disease, or an immune system problem, or if you have been told that you have poor circulation in your feet.
      • Pad pressure areas with doughnut-shaped felt, moleskin patches , or lamb's wool.
      • Never cut corns or calluses. Infection may develop.
      • Some lotions and moisturizers may also relieve symptoms from corns and calluses.
    • Blisters. Home treatment for blisters depends on whether the blister is small or large and whether it has broken open. See a picture of blisters .
    • Swollen ankles and feet. Try the following home treatment measures to reduce swelling in your ankles and feet:
      • Elevate swollen feet and ankles on a footstool or pillows (above the level of your heart) when sitting for any length of time.
      • Get up and walk around for a few minutes every hour if you sit for any length of time.
      • Cut down on your salt ( sodium ) intake or make a salt substitute. Sodium can be hidden in foods such as cheese, canned soups, and salad dressing. Talk to your doctor before trying a salt substitute.

    If you are diagnosed with a foot problem, other home treatment steps may help.

    Symptoms to watch for during home treatment

    Check your symptoms if any of the following occur during home treatment:

    • Pain or swelling develops.
    • Signs of infection develop.
    • Numbness, tingling, or cool, pale skin develops.
    • Symptoms continue despite home treatment.
    • Symptoms become more severe or frequent.

    Prevention

    The following tips may prevent toe, foot, or ankle problems.

    General tips

    • Bathe your feet daily in lukewarm (not hot) water. Use a mild soap, preferably one containing moisturizers, or use a moisturizer separately.
    • Avoid problems by wearing good footwear. Wear comfortable and supportive shoes. Support weak or unstable ankles by using a brace or taping before exercise or activities that increase your risk of problems.
    • Wear the correct size panty hose and stockings. Avoid wearing constricting garters, knee-high, or thigh-high stockings.
    • Use a rubber mat to stand on if your work requires you to stand on hard surfaces. This may reduce stress on your feet.
    • Maintain a reasonable weight for your height.

    Exercise tips

    • Do stretching exercises for the tendons at the back of the heels. This is especially important for athletes before sports activities but is also helpful for people who are not involved with sports.
    • Walk regularly to improve circulation, increase flexibility, reduce fatigue, and encourage bone and muscle development.
    • Establish good exercise habits and sports training techniques.
    • Consider consulting a sports-training specialist if you are a competitive or serious recreational athlete. He or she can recommend training and conditioning programs to prevent foot problems.

    Foot care tips

    Preparing For Your Appointment

    To prepare for your appointment, see the topic Making the Most of Your Appointment.

    You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

    • What are your main symptoms?
    • How long have you had your symptoms?
    • What were you doing when your symptoms started?
    • Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated?
    • What activities related to sports, work, or your lifestyle, make your symptoms better or worse?
    • Did foot problems begin after you started wearing new footwear?
    • What home treatment have you tried? Did it help?
    • What nonprescription medicines have you taken? Did they help?
    • Have you started any new medicines or have you had a change in the dosage of a medicine?
    • Do you have any health risks?

    Credits

    By Healthwise Staff
    Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
    Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
    Last Revised October 1, 2012

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