Painful Pinky Toe: The 5 Usual Suspects

The tiny toe that gets big abuse. A painful pinky-toe is the foot-finger I treat the most — and it's no wonder.

Tight shoes, your BMI and four fat digits bully the baby one. 

Sat down in the South Pole of your body, it's a warning beacon for potential threats. ​Hazards such as unstable ground, a kick too hard and....baseboards. 

​The drawback with these keen soreness sensors is the reason for pinky-toe pain can be tough to tell.  ​
​
​​Not to mention, it's not exactly easy for you to get a good look...

• Pinky toe pain is mostly due to excess friction and pressure
• Little toe's are vulnerable to tight shoes and loose ground  
• Remember, pinky toe nerves are hyper-sensitive
• That means big pain doesn't always equal a large bill

​Painful Pinky Toes (Don't Get No Love)

All it asks for is an occasional rest from shoes. And foot cream if it's super spoiled.

But what does your painful pinky toe receive? Picky socks, pointy shoes and smooth table legs in the dark. 

But, sensitive as they are, the majority of painful pinky toes are from easy-cure causes.

​Not that you'd think that if you online search...

​Paging Dr Google...

I just love searching for medical things only to discover some alarming condition. Of course, it'll cost a lot of time and funds to resolve.

(If it can at all) 

Well, you'll be glad to know this isn't one of those lists. 

Why?

Because for every ​baby toe break and bone spur I see, I treat 20 other (simple) cause cases. 

But: I'm Biased

Yep, I'm biased. Partisan, partial, whatever you want to call it. 

If you break your baby toe, you're going to have a hard time touching it, let alone walking.​ 

The same goes for a bruise-bad sprain. 

As it swells and blues, you're going to keep any weight the hell off it (before you get yourself to ER for an x-ray). ​​

​In other words, you'll know exactly what caused your painful pinky toe. The people I see usually don't. 

This is because most pinky toe pain takes a while to kick in. And this is due in no small part to how amazing our bodies are adapted. 

Triangle O' Toes

Think of your foot as an upside-down triangle (or nabla, if you didn't know).

Anyway, the pointy end is your heel; the wide wedge is your forefoot. 

Your body puts force from walking through the right side of the triangle. In other words: your big toe.

This is why the large digit and its bones are thick 'n' strong.

In comparison, the other side of the wedge - ​your pinky toe - is thin and flexible.

It's designed to adapt, to grasp, to get a sense of the ground — and this is what makes them vulnerable to stress. 

​And not just from the earth...

Tools and Tailor's (Toes)

In my line of work, pinky toes fused out of shape are the norm, not the exception. 

​​Years of crushing shoes force your little digit into permanent strain positions. Like Chinese bound feet.
​​
Known as hammer toes if they hook back, little toes also slide, twist or cross over n' under.

​Then we have tailor's bunions.

​This condition makes your pinky toe swing in, as the bone underneath drifts out. 

These little toe deformities make your baby digit grind flesh and fabric that it doesn't do out of shoes. 

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​Painful Pinky Toe Causes

1. Sprains, Strains And Breaks

Right, I want to get this out of the way first: little toe fractures are rare.  

At least, compared to other reasons I see. 

Your pinkie toe is so small that there isn't much leverage to force a bone crack. The amount of sensitive nerves means you recoil in agony way before the most serious damage. ​
​
Another plot twist: pinky toe stress fractures don't exist. 

That condition happens in the long bone (metatarsal) underneath it — which is also where you feel it.​

Bad Bruising

More commonplace are sprains, strains and follow-up bad bruises.

​This usually happens when you wear a new set of shoes and walk (or run) longer than you planned.

Throw in a tailor's bunion and voila. 

With breaks and sprains, the whole toe will hurt. In particular "up and down" movement. The ink-blue bruising is the main thing to look for.

​In this case, put your feet up (literally).

Put on an ice pack and see a doctor if it hasn't calmed down in 3-5 days. ​

2. Pinky Toe Friction

Good ol' rub and chafe. ​​I see lots of people with disabling pinky toe pain from friction alone. 

It starts as an aggravated itch that's pleasant to relieve rub. As the miles pass, it ​numbs, and acquires a crimson glow.

​Then comes the swelling, which takes ages to shrink.  

Warning Signs

These are warning signs: your painful pinky toe is being pushed and pinned against its will. ​

​Act now, or forever watch the red skin morphs into callus on your pinky toe. 

Nourish your tormented toe  and, for the love of god, wear some wider shoes.
​
(At least now and again)

3. Pinky Toe Callus

Callus is an escalation in the friction war. Your body grows tired of warning you (with pain) and throws down yellow, dry hard skin.

Its purpose is to protect you - and it does - but it also rasps the healthy skin underneath. 

The most common place I see callus is right in the center top. 

​Oh, I also treat a lot of pinch callus. ​This is where it collects in an unnatural taper at the bottom of your pinky toe.   ​

Pinky Toe Callus Removal

​If you want to remove callus you need no more than urea foot cream and a good emery board.  

(I use Gehwol Fusskraft Mint foot cream for my patients. It glides into your skin and smells like stalk-fresh mint leaves) ​

If you want to stop pinky toe callus from coming back full stop — well, that depends on where it is.

​Pinch callus means your pinky toe is under riding and a gel spacer will push it out.​ ​

​If you don't add space, you're at risk of the infamous soft corn.

3. Soft Corns Between Pinky Toes

Soft corns burrow into the inside meat of your pinky toe. 

Also known as heloma molle, they flare up from scissor-like chafing between your toes. ​

They're plugs of hard skin that resemble a cross between athlete's foot and a blister. Their calling card is an intense burn 'tween your toes. ​

(Think a campfire hot ember on the inside of your little toe)

Like all foot corns, they form when a protective callus has nowhere else to go but inward. Unlike other corns, these mushy lesions get damp from your sweaty toes. 

Air Dried

​Soft corns are agony. So painful in fact, that I see lots of people use acid corn plasters to get rid of them. 

The problem is that the already damp skin reacts nasty to the salicylic acid in corn plasters. Proceed with caution! ​

​To stop a soft corn safely you have to make space between your pinky toe and the one next to it.

Then, you need to reduce excess moisture as much as possible. ​

The best way to do this is with a gel spacer. 

(Rubbing alcohol dries out the wet soft corn and the separator stops the devilish friction)

4. Pinky Toe Hard Corns

Imagine the gravel from a bike track embedded in the top of your toe. Now imagine it twist with every step.

That's a pinky toe hard corn. In fact, their top symptom is immediate relief when you remove your shoes. 

(Video of me removing an early one here)

Like soft corns, they assemble when callus on top can't take anymore — and goes internal. 

Full-fledged hard corns are obvious. They resemble an oblong seed buried in the top of your little toe.

​Early hard corns are tougher to tell (look for seed corns, they usually come first).

Hard Corns, Easy Shoes

Hard corns on your baby toe means you've OD'ed on tight shoes. 

In other words, you need space ASAP. ​This alone will pause their relentless growth.

(This either means new ones or stretching your favorite pair)

​To remove a hard corn, if it's early enough you can often file and cream it away. Make sure you pick a good one with urea, like Gehwol. 

Unlike a soft corn, you can easily see (and hopefully reach) your pinky toe. 

​​If this doesn't work, corn plasters can, but only use them for the recommended time. 

5. Accessory Little Toenail 

​If you've got a split pinky toenail that always grows back, you may have a legit sixth nail. Not a split one, an actual mini toenail with a life of its own. 

Here in the UK, accessory toenails are called Lister corns (cos they look like corns when very small). 

They hold the dubious honor of the only problem nail outside of your big toe. 

Anyway, you pluck split baby toenails from your family tree. In other words, they're inherited. 

These split pinky toenails cause issues if you have a rotated-out fifth digit. Constant walk-chafe makes them thick and they press against their long-lost nail sibling.  

Losing a Lister Corn

Remember: they'll keep coming back. Yes, it's a pain but there's far worse foot issues you could have!

Now, in theory, you could have a split toenail removed via surgery. I'd say this is a last resort though. ​ 

Pinky Toe Gout?

(Two separate pinky toe gout cases. Both were very active and infused with tophi crystals)

Since I published this post, I've had a lot of emails asking about pinky toe gout. 

So, now I'm adding a 6th condition — gout in pinky toe. But I want to stress: it's not that common.

(It's usually heavy friction or chillblains)

Now, you can get gout anywhere; like your elbows and eyes.

But it's usually on your foot and tends to target your big toe. 

I've seen a handful of active pinky toe gout cases. It's not an easy condition to diagnoze 'till it starts to ooze tophi. 

​Women (Have Worse Feet Than Men)

Yep, and it's all down to those ballet-tight footwear.

Fashion is an integral part of your life. Society says so — like corsets.   

But it's not only shoes and buying apparel online is a double-edged razor. 

You can access stuff you'd never see down your McHigh Street for sweatshop prices.

Then it rocks up and looks (or fits) decidedly different from advertised.

If you've got Amazon Prime, use Try Before You Buy.

You can order six items (including shoes, kids and men's clothes) and cavort in front of a mirror trying them for 7 days. ​ You only pay for what you decide to keep. 

(Returns are free). ​

​Painful Pinky Toe​: The 5 Usual Suspects

So, there we have it, the pinky toe pain causes I see the most often. Almost always in fact.

(For the most common bottom foot pain causes, see this chart)

But also as always — use this as a guide and not as a substitute for a qualified professional. 

Pinky toes have a tiny tolerance for pain, and not all causes can be cured at home. The good news though, is that very few cases need anything truly life-changing to remedy.