Why Does My Fourth Toe Hurt?

The following is the fourth installment of our five-part series on why each of your toes may be in pain. You can learn more about why your big toe, second toe and third toe hurt by clicking the links to the blogs. Below, we take a closer look at what might be causing pain in your fourth toe.

Your fourth toe is another well-protected toe that isn’t commonly injured on its own, but know that injury to this toe can and does happen. If you’re experiencing new or worsening pain in your fourth toe, consider consulting with a specialist to get a better understanding of what could be to blame. Here’s a snapshot of some of the likely culprits:

Morton’s Neuroma – One of the most common reasons for discomfort in and around the fourth toe is caused by the presence of a Morton’s neuroma. A Morton’s neuroma develops when an enlarged nerve causes discomfort on the bottom of your forefoot. In most instances, the discomfort develops on or between the third and fourth toes on your foot. Switching to more supportive shoes or receiving a corticosteroid injection are two common treatments that may be used prior to surgically addressing the nerve.

Direct Trauma – Although the fourth toe is more protected than others, it’s still possible for it to receive direct trauma. A heavy item falling on your foot or stubbing your last two toes on an object can lead to bruises and fractures, although in these instances it’s typically pretty obvious why your fourth toe is in pain. In most instances, fourth toe fractures heal just fine on their own without surgical intervention.

Hammertoes – When you wear shoes that are a little too tight, your toes end up bending or curling under to account for this lack of space. This can damage the supportive soft tissues in the toes and lead them to bend at the joint or curl under even when you’re not wearing shoes. This is known as mallet toe or a hammertoe, and it’s most common on your second, third and fourth toes. Getting into a better fitting shoe before the damage becomes more extensive is crucial for fully treating the condition.

Brachymetatarsia – Brachymetatarsia is a rare condition that can lead to a shortening of one toe, oftentimes the fourth toe, because of a growth defect with the metatarsal attached to the toe. It can also develop if a growing child experiences trauma to the growth plate during a stage of growth and development. Sometimes the condition only causes cosmetic issues, while some also present with pain and discomfort. You’ll want to connect with a specialist who understands brachymetatarsia if you want to determine the best path forward for your foot.