Shooting pain, dull pain, aching pain in your toes. There's nothing quite like it, is there? You can change footwear or buy over the counter insoles, but those measures only go so far. Ultimately, your toe pain will still be there, and may even get worse over time. Here then are the nine most common causes of toe pain and what your podiatrist may suggest as the best way to alleviate them.

[caption id="attachment_4690" align="alignleft" width="300"]No apparent problems with these toes - they're just the way they're supposed to look.[/caption]

The 9 most common causes of toe pain

1. Arthritis is an inflammatory disease which attacks the joints in your body. It's one of the most common causes of pain in the toes, as our appendages frequently show the early signs of this disease. Arthritis can also occur in previously fractured areas of bone and sprained joints injured years earlier.

Treatment: Rest when necessary, use over the counter pain medicine like advil or aleve to manage the pain and inflammation. Custom orthotics can be helpful in relieving the pressure on toes. If pain is intolerable, visit your podiatrist.

**A stiff big toe which is also painful at the joint may be a degenerative form of arthritis called Hallux rigidus. Read more about Hallux rigidus.

2. Gout, a form of arthritis (also called gouty arthritis), is caused by uric acid buildup in the joints. Gout causes severe pain and swelling in the joints, most commonly in the big toe.

Treatment for gout includes prescription or over the counter medications to manage the pain, and ice to reduce swelling. Gout is also treated with dietary changes to reduce uric acid output.

3. A bunion is a protuberance in the joint below the big toe. Anyone can develop a bunion, which is caused by defects in the biomechanical structure of the foot. While poor choices in footwear do not directly cause bunions, they certainly aggravate the condition. Hammer toes and overlapping toes frequently appear with bunions.

Treatment for bunions includes changes in footwear and/or custom orthotics to take pressure off of the bunion, over the counter pain medicine to manage the pain and inflammation, and surgery when necessary.

4. Hammer toes occur when the middle joint of the second, third or fourth toe becomes bent, giving the toe a hammer-like appearance. Hammer toes are caused by an imbalance in the muscles and tendons, which pull incorrectly in the foot, ultimately bending the toe.

Treatment of hammer toes includes changes in footwear to keep the hammer toe from rubbing on the inside of the shoe, and stretching exercises to strengthen the muscles and tendons. Your podiatrist may also recommend custom orthotics or surgery when necessary.

5. Overlapping toes, underlapping toes and crossover toes are deformities in which one toe crosses over or under the adjacent toe. Overlapping and crossover toes are each caused by abnormalities in the biomechanics of the foot, but for different reasons.

Treatment of overlapping toes, underlapping toes, and crossover toes includes over the counter pain relievers, stretching exercises, and splints to hold the affected toes in place. Only surgery can correct these conditions permanently, however.

6. Ingrown toenails occur when the skin on the side (or sides) of a toenail grow over the nail. Ingrown toenails can be incredibly painful and become infected if not treated.

Treatment for ingrown toenails includes soaking the foot in warm water four times each day, and treatment by a podiatrist to remove the skin and/or treat the infection.

7. Turf toe, most comonly occuring in athletes, is an overuse injury that occurs at the base of the big toe. It is usually the result of a hyperextension of the big toe, but may also be a form of sesamoiditis or sesamoid fracture (the sesamoids are two tiny bones in the ball of your foot).

Treatment of turf toe should always be handled by a podiatrist familiar with sports injuries.

8. Fractures can occur in any bone of the toe. A minor fracture needs only rest, ice, and if necessary, over the counter pain medicine to heal. But serious toe fractures must be immobilized and if extensive, may require surgery. Toe fractures should always be treated by a podiatrist.

9. A toe sprain occurs when the toe is jammed or stubbed, and the tendon or soft tissue is injured. Even though this injury can look quite nasty, the pain and swelling should subside in a few days, if there is nor fracture.

Any pain in your toes is not normal. Please make an appointment with the PA Foot and Ankle Associates office if you're experiencing any of these symptoms.