Even though toes are small, injuries to the toe can often be painful. A fracture (break in the bone) may result from a direct injury, such as dropping a heavy object on the foot or by accidentally stubbing or kicking the toe against something. It may be badly bruised or fractured. On examination of your toe, if there is no deformity, your toe might not be x-rayed as an x-ray will not change the treatment of your injury. Injured toes are extremely painful and will often be swollen, red and bruised.
Treatment
- The preferred treatment is to strap the injured toe to the one next to it (neighbour strapping) and can be worn for up to 2 weeks if provided. Not everyone needs or likes this. The healthy toe will act as a splint while your toe heals. This is not always required and can be discontinued when your injured toe feels comfortable. A hard soled shoe may also be provided by the Accident and Emergency Department.
- Start to wiggle your toes as soon as you can.
- You can change the strapping at home if it becomes wet or dirty.
- It is recommended that you wear supportive and closed footwear with plenty of room for your toes for the first 4-6 weeks. Avoid wearing shoes such as sandals, Crocs or flip flops.
- The pain is worse in the first few weeks, but you may experience some discomfort for longer. If there is a fracture it can take up to 12 weeks for the bone to heal. If it is a soft tissue injury, it will heal within 2-3 weeks.
- It is advisable to rest and keep the foot elevated as much as possible, especially during the first 2 weeks. This will help reduce swelling and decrease pain.
- You can take simple painkillers as advised, or if you are unsure of which painkillers to take you can contact your GP practice for advice.
- No follow up appointment will be required, except if you have broken your big toe. A big toe fracture is normally reviewed by the Orthopaedic Team as a big toe is important in maintaining our balance.
- You can begin normal activity once the swelling has gone down and you are able to comfortably wear a protective shoe.
- It takes up to 6-12 weeks to recover from this injury.
- If it has not started to improve by 6 weeks, seek further opinion.
- Smoking is known to delay healing and can prevent it all together. If possible, we would advise you stop. Further advice can be found on the NHS website or from your GP.
During the first three days
- Rest the toe by not walking or standing for too long. You may find it more comfortable to walk on your heel for the first few days.
- Ice will help reduce swelling and help with the pain within the first 24 to 72 hours. Place an icepack (or bag of frozen peas) wrapped in a tea towel over the affected area for 5-10 minutes every 2-3 hours.
- Elevate the foot (higher than your hip) as much as possible in the first 24 to 72 hours as this will help reduce pain and swelling.
- Pain and swelling is normal therefore you should take simple pain killers such as Paracetamol.
- Wear a sturdy shoe to protect the toe and do not squash or bend the toe.
When to go to hospital
Go to your nearest Accident and Emergency Department if:
- Your toes are cold and numb or tingling
- The skin on your toe has turned blue
Please contact your GP or NHS111 for any queries or concerns
Reference: Lesser Toe Fracture or Dislocation Leaflet, Orthopaedic Department, Wirral University Teaching Hospital NHS Foundation Trust
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