What Does It Mean When Your Big Toe Is Swollen & It Hurts on Top?

A man is holding his foot.
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People who feel that a tight, snug shoe is a good shoe, may need to consider the consequences of this opinion. Many people, especially those who played sports in school wearing cleats or spikes, translate the tightness of their sport shoe to their everyday-wear shoe, for the remainder of their lives. With all the standing, walking, running and impact your feet receive on a daily basis, it's no wonder that your big toes are swollen and hurting.

Shoes for Your Foot Type

Finding an athletic or work shoe for your foot type is a good place to start keeping your big toe healthy. Big toe pain and swelling can be caused by wearing a shoe that is incorrect for your foot type. Find out if you require a neutral, stability or motion control shoe, then choose one designed for your foot. The proper function shoe can relieve any excess pressure or impact on your big toe. Ask your local footwear expert to assess your foot type, or take the wet test. Wet the bottom of your foot, stand on a brown paper bag or dark surface, and note if you have a high arch or a neutral, low arch, or if you have a moderate overpronating, or a flat, severely overpronating foot.


Wearing a shoe too small and not wide enough is a big factor in contributing to big toe soreness and swelling. The University of Iowa Hospitals & Clinics recommends buying a shoe that has a half inch of room in front of your big toe to reduce any chance of unnecessary impact. The organization also suggests that you fit the shoe to your biggest foot to reduce the likelihood of big toe injury. A shoe should feel comfortable from the get-go, and should never have to be broken in. While it may be recommended to have your feet measured, it is better to simply try on shoes and fit to your foot size, as shoe sizes can vary greatly from model to model, and brand to brand.

Medical Issues

Your shoe sizing may not be the only issue that can contribute to big toe swelling and pain. The Mayo Clinic notes that gout is a complex form of arthritis that mainly causes the big toe to swell and become red. Gout is caused by a concentration of uric acid, which creates crystals in your big toe joint, and is more likely to affect men and older people. A swollen big toe due to gout is one reason to buy a shoe with a roomy toe box in order to reduce any impact and pressure. Also, anti-inflammatory or steroid medications may be used to reduce and treat gout symptoms.

Other Factors

When trying on shoes, do so later in the day to account for normal swelling of your foot due to gravity and impact. This will allow you to choose a larger shoe size to give your big toes more room. Women need to be wary of wearing high heels too much, as the compression of the pointed toe, and the angle of pressure on your toes, especially your big toe, can increase the likelihood of big toe issues.