Inflammation in the big toe


Many people experience inflammation in different parts of their feet. The inflammation is particularly often localized on the big toe.

There are several causes that can lead to such inflammation.
Often they are Inflammation of the nail bed (also Onychia or Paronychia called), which cause painful inflammation of the big toe.
Small injuries to the skin very often cause nail bed inflammation. As a result of the injury, germs migrate into the tissue, mostly the bacterium Staphylococcus aureuswho then a Inflammation of the nail wall entail.
However, the germs can also penetrate deeper, resulting in a Panaritium, a purulent inflammation of the toe develops.

This type of inflammation is usually associated with one Incision treated.
That means that you can get the affected tissue through relieves a cut and supplies the inflamed tissue.
Since such a panaritium on the big toe is often caused by an ingrown toenail, part of the nail root usually has to be removed.

Inflammation of the big toe also occurs in the Framework of metabolic diseases like the gout on.
Then one is needed here systemic therapy, as local measures alone cannot make the inflammation go away.

The following article would now like to deal with the causes, symptoms and the treatment of inflammation in the big toe in more detail, covering as many questions as possible.

Causes of Inflammation in the Big Toe

The causes of inflammation in the big toe are diverse.
Often they are Inflammation of the nail wall or nail bedwhich can cause painful swelling and reddening of the toe.

However, there are also metabolic diseases like that Hyperuricemia, colloquial gout called into consideration.
The following section provides an overview of various more or less common causes of inflammation of the big toe.

  • Onychia / Paronychia / Panaritium:

These terms are mostly used synonymously. However, the term nail bed inflammation is much more common in everyday parlance.
It can often be very difficult to correctly distinguish the terms. What they have in common is that it is all about Inflammation of the fingers or toes acts.

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At a Onychia is above all that Inflamed nail bed.
A Paronychia rather means a Inflammation of the nail fold (synonym nail wall).
In the case of paronychia, there may also be a purulent fusion in the tissue.
A Panaritium on the other hand is a localized, purulent-melting one Inflammation of the fingers or toes.
Panaritium occurs less often on the toes than on the fingers.

The inflammations are very similar in their clinical picture and ultimately differ in their Expansion and heaviness their symptoms as well as partly by their location.

Usually they arise through minor injuries, for example the finest cracks on the cuticle, through which mainly skin germs such as Staphylococcus aureus, enter the tissues and cause inflammation.

The big toe often has a ingrown toenail (Unguis incarnatus) the cause of such inflammation.
Also one poor foot hygiene or one Fungal infection the feet can be the cause.

Typically, this inflammation leads to one Swelling, redness, and overheating of the big toes, which is accompanied by a characteristic throbbing pain.

With advanced inflammation and systemic involvement, symptoms such as fever, chills, and fatigue are also possible.

The therapy depends on the severity of the inflammation and can follow local or systemic conservative approaches, but also require surgical measures.

  • Acute attack of gout:

More than 60% of the acute gout attack manifests itself in the metatarsophalangeal joint of the big toe. This inflammation manifests itself as a very sudden onset of acute swelling and reddening as well as very severe pain in the toe. Some sufferers report a feeling “as if their toe was broken”.
The examination is often not tolerated at all due to the severe pain. Such a gout attack on the toe (podagra) is typically triggered by excessive alcohol, meals rich in meat and fish, or fasting.

  • Rheumatoid arthritis:

Rheumatoid arthritis can also be a cause of inflammation of the big toe. Usually, however, the finger joints are affected, and typically several joints are affected. Concomitant symptoms such as night sweats, muscle pain and slightly elevated temperatures can also occur. The disease progresses in phases.


Gout is an episode of one Protein metabolism disease, more precisely the purine metabolism.
The underlying disease is called Hyperuricemia. If the uric acid level in the blood is too high, uric acid crystals are deposited on various parts of the body.
There are different forms and causes of Hyperuricemia, however in 99% of the cases there is a genetic disposition before, in which the gout then manifests itself through malnutrition.

A low-meat diet, as well as a Reduction in alcohol consumption.

In addition, being overweight promotes gout, so normalizing body weight is particularly important in chronic gout.
A acute gout attack manifests itself in over 60% of cases as so-called Podagra. This is a E.Inflammation of the metatarsophalangeal joint of the big toe.
The triggers are usually a very meat and fish-rich diet, legumes or seafood.
Excess alcohol or fasting can also lead to acute podagra.
There is a sudden, very strong pain, as well as swelling and reddening of the joint.

The examination of the toe is then usually felt to be so painful that it is not allowed. Occasionally, there is also a fever.
An acute attack of gout can last several hours and is treated with NSAIDs (e.g. diclofenac) and glucocorticoids.
Colchicine is also used as a reserve. It also helps keep your toe up and cool.

Symptoms of inflammation in the big toe

Inflammation of the big toes can show different symptoms depending on the underlying disease.
However, non-specific symptoms of inflammation are common to most inflammations of the big toe.

There is swelling, redness and overheating of the toe. Read more about the topic here: Swollen toe

The swelling may be confined to the nail bed or fold, or it may affect the entire toe.
The latter is often the case with an acute attack of gout. The pain varies in intensity, but is mostly described as stabbing and throbbing.
They worsen when touched and moved.
If the pain is very pronounced, the mobility of the toe may be restricted, so that a relieving position is adopted.

In addition, the symptoms differ in their onset.
While nail bed inflammation sometimes begins more insidiously or can be characterized by a slow and progressive (worsening) course, a gout attack begins (Podagra) all of a sudden and manifests itself as very severe pain.
Depending on the extent of the inflammation, one can Panaritium or one Paronychia purulent spots can also be seen.
If the inflamed cuticle bursts, pus or blood can also leak out.
Systemic or widespread deep purulent inflammation can also lead to generalized symptoms such as fever, fatigue, and chills.

Read more on the topic: Pus on toe

With a systemic infection and a large abscess in the toe, in the worst case scenario, without timely therapy, blood poisoning can occur.

A rheumatic inflammation the big toe is less common. Usually other joints are also affected, often the metatarsophalangeal joints of both hands.
In addition to the local symptoms of inflammation such as pain, redness and swelling, other symptoms such as night sweats, a slight fever and muscle pain can occur.

Inflammation of the ball of the big toe

The "ball" of the big toe can become inflamed if through Injuriessuch as cracks or abrasions, germs enter.
These can become a purulent infection of the tissues which in turn can be very painful.
As part of joint or Inflammation of the nail bed the bale can also be affected.
However, an isolated inflammation of the ball is unlikely except in the case of a wound infection.

In the context of a deep inflammation of the nail bed, however, purulent involvement of the ball is likely.
A so-called Hallux rigidus hinders the rolling movement of the toe while running and thus leads to Pain in the ball of the foot.
Strictly speaking, hallux rigidus is not an inflammatory one, but one degenerative disease of the metatarsophalangeal joint.
That means it is a Joint wear acts.

Inflammation in the joint of the big toe

Inflammation of the metatarsophalangeal joint of the big toe is mostly based on primary hyperuricemia and then manifests itself in one acute gout attack.
This type of inflammation comes from what is called the build-up Urate crystals in the joint.
These are uric acid crystals that are formed when there is an excess of uric acid in the body.

An acute attack of gout manifests itself in over 60% of cases as Podagra (acute manifestation in the metatarsophalangeal joint of the big toe) and is accompanied by severe pain, which can last for several hours.
This painful "inflammatory attack" is triggered by meals that are very rich in purine, such as meat and fish, alcohol consumption or fasting.
Another cause of inflammation in joints of the big toe is rheumatic complaints.

In principle, all joints can be affected, but hands and feet are particularly common in one rheumatoid arthritis affected.
Autoantibodies, which are present in rheumatoid arthritis, are responsible for the inflammation.
The pain then tends to occur in bursts and is mainly improved by painkillers such as Diclofenac or glucocorticoids like Prednisolone.
Rheumatoid arthritis never occurs in isolation at a jointso that other joints on the foot or other parts of the body are most likely also affected.

Other causes of pain in the big toe joints include Trauma, Fractures or Signs of wear and tear like osteoarthritis. However, these are not inflammatory diseases.

Inflammation on the nail

Often the cause of inflammation in the big toe is that the nail or parts of the nail bed or cuticle are inflamed.

This inflammation can be limited to the nail wall, for example, but it can also reach deeper and cause an abscess.
Very often are ingrown toenails (Unguis icarnatus) the cause of recurring inflammations such as Panaritia or one Paronychia.
These can occur in families or due to the Wearing shoes that are too tight or one false nail care caused.
The result is that the nail grows into the nail bed painful inflammation and small woundsthrough which germs can then migrate into the tissue.

Another cause of inflammation on the nail or the nail bed is smallest wounds on the nail wall (also called nail fold).
These small wounds mainly cause skin germs such as Staphylococcus aureus into the tissue and cause there infectious inflammation.
Depending on which part of the cuticle or the deeper tissue is affected, one speaks of one Onychia, Paronychia or one Panaritium.

For small, locally limited inflammations, one is usually sufficient local therapy with an antiseptic or antibiotic ointment and cooling bandages.
Deeper inflammation will be with one cut (Incision) so that the pus can drain away (drainage).
In the case of systemic symptoms such as fever or an impending spread of the inflammation, additional Antibiotics administered.

Therapy for an inflammation in the big toe

Therapy for inflammation of the big toe depends on the underlying cause.
Often procured Cooling and elevated storage of the affected toe provides initial relief for those affected.

At a infectious inflammation of the nail bed or des deeper tissue (Paronychia or Panaritium) the therapy depends on the extent of the findings.
A mild and localized inflammation can be treated with an antiseptic ointment or with Antibiotics be treated.

At a Fungal attack become antifungal ointments applied.
However, if there is a widespread inflammation, an abscess or even systemic symptoms such as fever, that will cut open inflamed area (Incision) and drained.
This means that any pus that is present is removed. Smears are also taken to determine the pathogen.

Should dead tissue or a ingrown toenail are present, these are also removed.
The toe is then immobilized.Antibiotics are also given for deep infection and systemic symptoms such as fever.

Inflammation due to a gout on the other hand, the therapy is completely different. This is where this acute attack results (Podagra) by the deposition of uric acid crystals in the metatarsophalangeal joint of the big toe.
It will acute with so-called NSAIDs (Non-steroidal anti-rheumatic drugs).
These are anti-inflammatory and pain relieving agents such as diclofenac and indomethacin.
Furthermore will Glucocorticoids (Prednisolone) administered.
Since both drugs together can damage the stomach, usually another Stomach protection like omeprazole administered with.

Colchicine is used as a reserve. The toe is also cooled.

So that such gout attacks do not occur again and again, then is one Long term therapy indicated in symptom-free patients Diet measures (low-meat diet, reduction in body weight, reduction in alcohol consumption, adequate fluid intake).
In patients with recurring gout attacks, the drug is also used Allopurinol used.

The therapy one rheumatoid arthritis comprises a number of different measures.
In the acute episode, pain reliever drugs such as NSAIDs are also administered.
Cooling the toe also helps.
In long-term therapy there are a large number of drugs that are used. Among other things, these are basic therapeutic agents such as Methotrexate or Biologicals like infliximab.
They also have rheumatoid arthritis too Movement therapy approaches like physiotherapy and physiotherapy are very important.

Therapy of an inflamed toe with ointment

Inflammation of the big toe can be treated with ointment.

Ointments can usually be used in acute inflammation Relief of the discomfort procure. Sometimes they can also lead to an inflammation healing.

At acute painFor example, in the context of gout, a cooling ointment can relieve the pain.
Infectious inflammation will be happy with antiseptic and antibiotic ointments treated.
The antiseptic component cleans and disinfects the affected area, while an antibiotic agent also fights the bacteria that cause the inflammation.

However, such ointments can only heal if the Inflammation is localized and has not spread in depth or led to a systemic disease.
You can still accompany one surgical or systemic therapy be applied.
There are several different antibiotic ointments available, some of which are over the counter.
It is best to seek advice from a doctor and a pharmacist on dosage and use.

To local application Ointments are often made with the active ingredients Fusidic acid or Retapamulin applied.
Furthermore, an antiseptic ointment with the active ingredient will be happy Povidone iodine used.
Examples of this are betaisodona or Braunovidone ointment.

At a Fungal attack of the big toe antifungal tinctures or ointments applied that fight the fungus.
Active ingredients contained are for example nystatin or naftifin. There are also ointments that are used to help heal and alleviate the symptoms.
These include, for example, ointments with the active ingredient ammonium bituminosulfate (also called ichtyol), which, under the trade name "Black ointment Lichtenstein" on sale is.

Another over-the-counter ointment that is often used to relieve symptoms is that Burn and wound gel Medice®.
It also has a cooling effect and supports healing.

There are a large number of other ointments that are very similar in composition to the ointments already mentioned.