Bump on Toe: Causes and Treatments

The foot is a complex region that consists of 33 joints and 26 bones. Each of these structures must work together to make everyday tasks like walking and climbing the stairs possible.

When a painful toe bump develops in this region, the intricacy of the area can make it difficult to determine the cause of your issue. Honing in on the location of the bump and the symptoms associated with it can help you determine how to best address the problem.

This article will outline the various causes of a toe bump and the ways to treat each variety.

Causes of Bumps on the Toe

Many different underlying conditions and activities can lead to the development of a painful toe bump. Fortunately, paying attention to the area of the foot where the bump occurs and any other coinciding symptoms can help clue you in on a potential cause. Some of the most common diagnoses are listed in the sections below.

Bunions (Hallux Valgus)

Bunions—also known as hallux valgus (HAV)—occur when your big toe begins to point to the pinky toe (or lesser toes). This typically arises slowly over time and can eventually lead to a painful prominence on the outer border of the base of the big toe. Other types of bunions, called tailor’s bunion or a bunionette, can also develop on the lateral base of the fifth toe as it deviates medially (towards the midline).

It is not entirely understood why bunions occur; however, certain foot types or anatomical variations may make this condition more likely to present in some people. Along with a painful bump, bunions may also cause redness, burning, or numbness in the area of the prominence.

Treatment

To help control symptoms:

• Switch to shoes with a wider toe box
• Use padding over the bunion
• Avoid painful activities

That said, surgical correction may be necessary if conservative measures fail to address the pain.

Bone Spurs (Osteophytes)

The ends of the bones in our body are covered in a smooth, slippery surface (called articular cartilage) that helps one bone move easily against another. Sometimes, as a result of an acute injury or chronic wear and tear, this cartilage begins to wear away. When this occurs, the excess friction can cause bone spurs (osteophytes) to form.

Bone spurs can develop in any area of the body. In the foot, they commonly occur at the first digit (hallux limitus) on the top side of the toe bones and can cause a painful bump to develop in this area. Other symptoms include pain or stiffness while walking (especially as you push through the toes) and swelling in the forefoot or toe regions.

Treatment

To help reduce symptoms:

• Ice the affected area
• Take NSAID (nonsteroidal anti-inflammatory drug) pain relievers
• Switch to a wider-toe box or rigid-soled shoe

If conservative methods do not relieve symptoms, surgery may be recommended. Procedures may include:

• Arthrodesis (surgery to remove the spur and fuse the toe joint)
• Arthroplasty (joint replacement)

Ganglion Cyst

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A ganglion cyst is a pocket of fluid that can develop in the capsule surrounding a foot joint. It can also form on the tendon of numerous foot or toe muscles. Typically seen on the top of the foot or toes, these cysts can be either small or large and may resolve and reappear sporadically. While their specific cause is still debated, it is thought that chronic micro-trauma or an acute injury in the region may be to blame.

Most ganglion cysts are asymptomatic, though they may cause some soreness if they are located on a tendon or joint. Occasionally the cyst may compress a nearby nerve, causing tingling or burning sensations. Typically, the cyst is relatively mobile and squishy feeling to the touch.

Treatment

If your cysts aren't causing symptoms, no treatment is needed. If you are experiencing symptoms, your healthcare provider may suggest:

• Draining and steroid injection
• Aspiration to remove fluid
• Surgical removal (there is a chance of regrowth)

Bursitis

Bursas are fluid-filled sacs that help reduce the friction between bones and tendons. Occasionally, direct trauma to the area or a repetitive activity (like jumping or running) can cause the fluid in these sacs to become inflamed and swollen. This is called bursitis and is a relatively common occurrence in the bottom of the feet near the base of the toes.

When bursitis develops, it can lead to pain, swelling, redness, and the development of a prominent bump in the area.

Treatment

To help resolve the issue:

• Modify activity
• Ice
• Take anti-inflammatory medication
• Use cushioning or orthotics

Occasionally, a corticosteroid injection to the bursa may also be needed.

Myxoid Cysts

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A myxoid cyst is a pea-sized cyst that occurs close to the nail bed at the end of a finger or toe. Myxoid cysts are sometimes called digital myxoid cysts, mucous cysts, mucous pseudocysts, or digital mucous.

These cysts are noncancerous (benign) and typically do not cause any pain. While some myxoid cysts require treatment, many will resolve on their own. For some people, myxoid cysts can recur.

Treatment

Most myxoid cysts are treated with non-surgical options. This may include:

• Cryotherapy (liquid nitrogen)
• Needle aspiration (puncture and drain)
• Steroid or sclerosant injections (injecting with steroids or other medicines)
• Cauterization (drain, then place silver nitrate in the cyst's space)

With any of these nonsurgical options, the cyst may return. 

Corns and Calluses

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Corns and calluses develop when repetitive rubbing or friction on the toes leads to the development of a thickened patch of skin.

Corns and calluses are typically rough or coarse feeling to the touch and may look similar to a common wart. While this dense layer of skin is meant to protect the toes from irritating pressure, it can cause pain in the area if it becomes too thick or prominent. A small amount of callus can be healthy, but it can be painful if it's too thick.

Treatment

Asymptomatic corns and calluses receive no treatment. Surgical debridement by a podiatrist may be needed to relieve soreness or irritation.

Gout

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Gout is a form of inflammatory arthritis caused when excess uric acid builds up in the body and forms sharp, microscopic crystals within a joint. Occasionally, these crystals can also clump together around the joint in masses (called tophi) that look like small nodules beneath the skin.

While gout can occur in any area, the medial side (closer to midline) is very commonly affected. The condition typically comes on without warning and leads to excruciating pain, swelling, warmth, and sensitivity in the affected region. It can also make it difficult to walk, wear socks, or even place a bedsheet over the foot.

Treatment

To help resolve the issue:

• Anti-inflammatory or uric acid-lowering medication (called colchicine) are common treatments
• Oral steroids or steroid injections may be necessary

Gout flare-ups may occur sporadically and can be prevented with medications designed to lower your resting uric acid levels. Your diet can also help prevent gout.

Rheumatoid Nodules

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Rheumatoid nodules are one potential side effect of rheumatoid arthritis, a disease that causes the immune system to attack its own cells. When cells in the body’s joints are attacked, it can lead to inflammation, pain, and stiffness. In more severe cases, round lumps called rheumatoid nodules may also develop under the skin.

These nodules can occur near any joint or area where pressure occurs, including the toes. Typically, the lumps are round in shape and doughy feeling. Nodules can be as small as a pencil eraser or as large as a fist and are typically not tender to the touch.

Treatment

Asymptomatic nodules receive no treatment. Nodules that compress a nearby nerve or limit joint movement may need a corticosteroid injection or surgical removal.

Lipomas

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A lipoma is a deposit of fatty tissue that forms into a tumor. This type of non-cancerous lump is usually located under the skin and is a soft and rubbery feeling. While most are commonly found in areas like the upper back, shoulder, buttocks, or thighs, occasionally lipomas can also grow on the toes.

Treatment

Asymptomatic lumps receive no treatment. If the tumor is growing or causing pain it may be surgically removed.

Other Causes

While the conditions discussed above are the most frequent causes of a bump on your toe, other less common diagnoses may also be to blame.

Skin Tags

In some instances, skin tags may appear around the foot or toes. These brown or flesh-colored growths are benign and are commonly small in size and attached to the skin via a narrower stalk. Skin tags are asymptomatic and are usually removed for cosmetic reasons only via cauterization or cryotherapy.

Warts

Along the same lines, warts may also grow in the forefoot or toe regions. These growths, which are caused by a virus infecting the skin, typically have a raised, coarse surface that is round in shape. Occasionally, a wart can cause pain particularly if it presses against your shoe or into the ground while you walk. While there are some over-the-counter wart medications, the most successful treatment is surgical removal by a podiatrist.

Cancerous Tumors

Finally, in extremely rare cases, a cancerous tumor can be to blame for your toe bump. In addition to a visual lump, a malignant growth in the toes can also cause pain, difficulty walking, swelling, and a fever. Treatments vary depending on the type of tumor; however, surgical removal, chemotherapy, and radiation are generally utilized.

Home Remedies for Bumps on the Toe

While concerning lumps should always be evaluated by a healthcare provider, there are a few primary steps that may be help relieve some of your symptoms:

• Ice and a compressive wrap can be applied to the toes to reduce any pain, redness, or swelling that is present.
• Over-the-counter NSAIDs may also help address the inflammation, though these can cause side effects and should not be taken without your healthcare provider's approval.
• Abstain from pain-causing activities.
• Regularly elevate the leg.

When to See a Healthcare Provider

If you notice a new bump on your toe or a recent enlargement of a pre-existing growth, it is important to have your foot examined by a healthcare provider. This is especially true if the bump is painful or if you are experiencing other symptoms like swelling or discoloration.

While most toe bumps are asymptomatic and can be well-managed at home, some are not and should be treated immediately. A physical evaluation is usually necessary to determine the cause of your specific toe issue and the appropriate treatment strategy. 

Summary

Many different diseases and conditions can cause a bump on the toe. Some, like a lipoma, a skin tag, or a ganglion cyst, can be asymptomatic and are usually left untreated. Others, like gout or a malignant tumor, should be addressed immediately by a healthcare provider. Paying attention to the appearance of the growth and any coinciding symptoms can help you determine the cause.