Swelling of the toes may be caused by trauma, physical strain, or an underlying medical condition. Broken bones or bruised ligaments and tendons following blunt trauma often results in puffy toes. Tendinitis and muscle inflammation frequently affect athletes and those who engage in exercise involving the legs. Other physical issues that may be responsible for enlarged toes include gout, infection, allergic reaction, blood clot, and arthritis. Some types of toe puffiness may be attributed to ill-fitting footwear or environmental irritants.
Traumatic injury to the toe often occurs when something heavy is dropped on the toe, or the foot collides with an object during physical activity. Broken bones and bruising can cause puffy toes, and an x-ray will often be used to determine the severity of the injury. Strained ligaments may also cause swelling when the trauma causes the toes to bend or stretch in an unnatural fashion.
Those who are physically active may gradually strain the toes, especially when they haven't properly stretched before exercise, or are working out too strenuously. Puffy toes caused by gradual strain may not be immediately obvious, and the injury may be severe and painful before the swelling is noticed. Inflammation of tendons, the tissue that connect the bones in the toes, may cause visual puffiness and pain as can trauma to the sacks of fluid that lay between tissue and bone. Joints in the toes may also swell and become tender to the touch.
Puffy toes that cannot be attributed to physical injury or strain may be the result of a medical disorder. Swollen toes are frequently associated with gout, a condition in which excess uric acid crystallizes in the joints and tendons, resulting in toes that are puffy, red, and hot to the touch. Other medical causes include arthritis, infection, and blood clots. A physician may extract fluid from the affected joint to determine the cause, and swelling from such conditions can usually be cured or controlled with medication or surgery.
Sometimes common irritants — such as allergens, hot weather, and restrictive footwear — can cause puffy toes. Allergies may be able to be controlled with medication or avoidance of triggers. Those who suffer from toe swelling without a medical explanation will often be advised to wear loose-fitting socks and shoes, and to stay barefoot whenever possible. An orthopedist or podiatrist may be able to recommend special hosiery and footwear designed to reduce swelling and promote circulation.