Why Do I Have Pain When Curling My Toes?

Jul 16, 2019

One thing we talk about again and again when patients are looking for a new pair of shoes? Make sure your toes have plenty of room to wiggle and curl!

However, for some people, the very act of curling their toes can cause pain and discomfort. That’s not normal, and if you’re experiencing pain when curling your toes, it’s important to see a foot specialist like Dr. Patel right away.

There are a few possible explanations for why this might be the case. However, if you find that the pain occurs along the top of your foot when you curl your toes, one of the most likely possibilities is a condition called extensor tendinitis.

What Is Extensor Tendinitis?

In order to understand this condition, you need to understand how toes flex. 

The extensor tendons do a lot of the work here. They run along the top of the foot, connecting the powerful muscles on the front of the lower leg to the toes, and they are responsible for keeping your toes straight and pulling them upward away from the ground during each and every step you take.

If the extensor tendons become irritated and inflamed, it can become painful to curl your toes in a downward motion, as this will stretch the inflamed tendons beyond their capacity. Sometimes, extensor tendinitis will also cause swelling across the top of the foot.

How Can I Tell If I Have Extensor Tendinitis?

Although this is not a substitute for a professional diagnosis, you can perform this quick test at home. Flex your foot downward and have someone apply light resistance against the top of your toes. If pain increases on the top of the foot, then it’s likely (although by no means a guarantee) that extensor tendinitis is the culprit.

Common Causes of Extensor Tendinitis

Wearing shoes that do not fit your feet well or are laced too tightly can cause pressure on your feet and lead to this condition. For runners, hill running is often what leads to this problem: the way your feet have to work when going up or down a hill can affect the tendons on top of your toes.

There are a number of other contributing factors you should keep in mind:

  • Constant friction. Having your foot rubbing against a tight shoe, either from it being too small or being laced up too tightly, can cause extensor tendinitis.
  • Activity choice. Extensor tendinitis tends to affect people who spend long periods on their feet, especially people who walk or run on uneven surfaces or up and down hills.
  • Calf tightness. Tightness in the calf muscles places the extensor muscles under greater strain, making tendinitis more likely to develop.
  • Abnormal foot arches. People with high foot arches are more likely to have pressure on the top of their foot, and people with flat feet find their extensor tendons under more strain, both of which increase the chance of developing this condition.
  • Injury. Injuries such as dropping something heavy on top of your foot can also lead to extensor tendinitis.

Treating Extensor Tendinitis

The following conservative treatment steps are used to reduce irritation, inflammation and pain:

  • Rest. If it hurts, stop! Allowing time for the injured tendon to heal is essential for optimal recovery.
  • Ice. Apply ice to the area in pain for 20 minutes at a time to reduce pain and inflammation. Make sure to use a towel to protect your skin.
  • Medication. Use non-steroidal anti-inflammatories such as ibuprofen and naproxen to reduce pain and inflammation. If the pain fails to settle, we may suggest a steroid injection.
  • Shoe lacing. Either tie your knot at the side or leave out one of the lacing holes over the most painful area. (The shoes themselves may need to be replaced if they are too tight.) 
  • Exercises. Strengthening exercises for the extensor muscles help improve strength and endurance. Calf stretches can also help.
  • Orthotics. These versatile devices will provide padding and support to the foot, taking any undue pressure off the tendons.

Surgery to repair extensor tendinitis is rare and usually reserved for unique cases that do not respond to conservative treatment options.

What If It’s NOT Extensor Tendinitis?

As we said in the beginning, extensor tendinitis might be the most likely culprit for pain when curling your toes, but it’s not the only possibility. In particular, metatarsal stress fractures share a lot of common symptoms with extensor tendinitis. Other potential causes include arthritis, gout, hammertoes, muscle cramps, and nerve problems.

This is why it’s so important to get a professional evaluation when you’re experiencing pain when curling your toes. Getting the correct diagnosis is the critical first step along the path to full recovery. Once we know what we’re dealing with, we can help ensure you get the treatment and support you need to address your pain.

Find Expert Foot Care at Family Foot Care & Surgery Today

If you are experiencing pain on the top of your foot (or anywhere else in your lower limbs, for that matter), contact Family Foot Care & Surgery. Dr. Sanjay Patel can find the cause of your pain and get you started on the right treatment quickly.

Even minor toe pain can cause a hiccup in your life so don’t wait to call. Make an appointment at our office in Milford, CT by calling 203-876-7736 or in Hamden, CT by calling 203-288-4055.