Why Is My Big Toe Suddenly Swollen and Enlarged?

A Foot Specialist Explains the Possible Causes

As a foot and ankle specialist, I often see patients who are concerned because their
big toe suddenly becomes swollen, enlarged, or painful.
This change can be alarming, especially when it happens without a clear injury.

Sudden swelling of the big toe is not something to ignore.
In many cases, it is a sign of an underlying medical condition that requires proper evaluation.

Common Causes of Sudden Big Toe Swelling

Gout (Gouty Arthritis)

One of the most common causes of sudden big toe swelling is gout.
Gout is a form of inflammatory arthritis caused by a buildup of uric acid crystals in the joint.

It typically presents with:

  • Sudden onset of severe pain
  • Redness and warmth
  • Significant swelling of the big toe joint

Many patients describe gout attacks as occurring overnight or early in the morning.

Hallux Rigidus or Hallux Limitus

Arthritis of the big toe joint, known as hallux rigidus or
hallux limitus, can also cause swelling and enlargement over time.

As joint degeneration progresses, the toe may appear larger due to bone spurs,
inflammation, and joint thickening.

Infection

Infections involving the skin, nail, or joint of the big toe can lead to rapid swelling.
This may occur following:

  • An ingrown toenail
  • A cut or puncture wound
  • Diabetic foot complications

Infections often cause redness, warmth, pain, and sometimes drainage,
and should be treated promptly.

Trauma or Repetitive Micro-Injury

Even if you do not recall a specific injury, repetitive stress,
tight footwear, or minor trauma can cause inflammation and swelling of the big toe.

Bunions (Hallux Valgus)

A bunion is a structural deformity of the big toe joint.
When irritated, the joint may suddenly swell, become painful, and appear larger than usual.

When Should You See a Foot Specialist?

You should seek medical evaluation if big toe swelling is accompanied by:

  • Severe or worsening pain
  • Redness, warmth, or fever
  • Difficulty walking
  • A history of gout, diabetes, or arthritis

Early diagnosis allows for effective treatment and helps prevent long-term joint damage.

Sudden swelling and enlargement of the big toe is never “just normal.”
It is often your body’s way of signaling inflammation, infection, or joint disease.

With proper diagnosis and early treatment, most conditions affecting the big toe
can be managed effectively and without permanent damage.

Frequently Asked Questions: Gout vs Big Toe Arthritis

How can I tell the difference between gout and arthritis in the big toe?

Gout usually causes sudden, severe pain with redness and warmth, often developing overnight.
Arthritis tends to cause stiffness, gradual swelling, and pain that worsens over time.

Is sudden big toe swelling more likely to be gout?

Yes. Sudden onset of intense pain and swelling in the big toe joint is highly characteristic of gout,
especially in middle-aged and older adults.

Can arthritis cause the big toe to look larger?

Yes. Chronic arthritis can lead to bone spurs and joint thickening,
making the big toe joint appear enlarged over time.

Do gout and arthritis require different treatments?

Yes. Gout treatment focuses on controlling uric acid levels and inflammation,
while arthritis treatment focuses on joint protection, biomechanics, and pain management.