You may not have thought about it, but there are a lot of bones in your feet -- 28 to be exact. Fourteen of those bones are in your toes. Your big toe has two joints, and your other toes have three. At each joint, two bones meet.
If you have bumps on the joints of one or more of your toes, you’d probably like to know why and what you can do about it.
Bunions
A bunion is a bony bump on the side of your foot. It happens when the bones inside your big toe don’t line up like they should. Your big toe slants toward your other toes. The base of the big toe where the joint is sticks out to the side. Sometimes a bunion forms on the other side of the foot at the base of the pinky toe. Doctors may call these smaller bumps bunionettes or “tailor’s bunions.”
Bunions often start small and get bigger and more painful over time. They’ll get worse if you wear shoes that are too tight. They can get red and swollen. You might also feel a burning sensation or numbness. Bunions sometimes run in families. They also may affect people with other joint conditions like rheumatoid arthritis.
Most of the time, you can treat bunions with better-fitting shoes, bunion pads, or shoe inserts (orthotics). You can ice your foot to reduce swelling and take over-the-counter pain relievers. If none of this helps, you might need surgery to realign your toes.
Bursitis
Bursae are fluid-filled sacs that help cushion your joints. When these sacs get irritated, painful, and swollen, doctors call it bursitis. This can affect any joint, including the ones in your toes. Sometimes a bunion can lead to bursitis.
You can take over-the-counter pain relievers to ease the soreness and ice your foot to reduce swelling. If that doesn’t work, the doctor may give you a cortisone shot to help ease inflammation and pain. If your bursitis doesn’t get better, you may need surgery.
Corns
These calluses usually result from friction between your toe and an ill-fitting shoe. As you walk, your toes push up against the shoe and put pressure on your skin. The surface of your skin thickens and irritates the tissue underneath. Hard corns form on your toes. Soft corns form between your toes as they rub together. They look like open sores.
A doctor can trim thickened skin or use medicine to remove your corn. Shoe inserts (orthotics) can also help. It’s rare, but if a misaligned bone is causing your corns, you might need surgery to fix it.
Bone Spurs
As you get older, or if you have osteoarthritis, cartilage in your toe joints can break down. When this happens, a bony deposit can form in its place. This extra bone or bone spur often makes a bump at the base of your big toe. Your doctor will call this condition hallux rigidus. Your toe could get stiff, swell, and hurt when you push off to take a step.
If over-the-counter medications and ice don’t ease your pain and swelling, the doctor can give you a cortisone shot. They might also suggest a contrast bath, where you soak your foot for 30 seconds in water as cold as you can stand and then for 30 more in water as hot as you can stand. You should switch to shoes with a wide toe box, or you doctor might give you a special boot to wear.
If your foot doesn’t get better, there are three types of surgery for bone spurs:
- Cheilectomy treats mild damage by removing the spur and part of your foot bone to give your toe more room to bend.
- Arthrodesis, which fuses the bones together, is for more severe damage.
- Arthroplasty replaces your toe joint completely.
Gout Tophi
Gout is a kind of inflammatory arthritis. It happens when uric acid builds up and forms crystals that collect in your joints and cause pain. Gout can affect any joint, but the most common place for a flare is your big toe. Sometimes the uric acid crystals form visible bumps in joints. Doctors call these gout tophi. This usually happens to people who’ve had gout for some time. It’s rare, but if a tophus remains inflamed despite longtime treatment to lower your uric acid levels, a surgeon can remove it.
Rheumatoid Nodules
People with rheumatoid arthritis (RA) sometimes get rheumatoid nodules on their joints. These bumps usually show up on your fingers and knuckles, elbows, knees, and the backs of your heels. They can be firm or squishy. They vary from pea- to walnut-sized. The nodules usually don’t hurt, but it can seem that way if the joint they’re near gets sore during an RA flare. It isn’t clear what causes them, but they’re more likely to affect people who’ve had rheumatoid arthritis for a long time.
You don’t need to treat most nodules. But if they hurt or grow around a nerve, your doctor may give you a steroid shot or do surgery to remove the nodule.
When to See a Doctor
Toes have a big job to do. They help us walk and balance on our feet. So if you or someone you care about is having a toe problem, it’s worth having a doctor take a look.