Tag Archives: big toe pain

Subungual haematoma – Bleeding under Nail

Summary

Often very painful, a subungual haematoma is a blood blister or bleeding under your toenail, and will cause swelling and bruising under and around your toenail.

How did I get this?

Usually a result of trauma, you may have stubbed your toe, dropped something on it, or been stood on.

You may also see this condition after endurance events e.g. running or hiking, or after wearing shoes that sre too small.

If you are taking anticoagulant medication you should take extra care.

What can I do about it?

Painkillers may help, but avoid those containing anti-inflammatories such as ibuprofen.

Piercing the toenail to release the pressure will give immediate relief, but this should be carried out by a medical professional if possible.

What help can I get for this?

Your Doctor or Podiatrist will carefully release the pressure and fluid from beneath the toenail, and advise you on appropriate dressings.

Your podiatrist can help if the toenail comes loose, or is not growing properly.

When will it get better?

Releasing the fluid from beneath the toenail usually gives immediate relief. Sometimes you will lose the toenail, but it should grow back again.

Ingrowing toenail

Summary

  • Ingrowing toenails occur when the hard nail plate causes a wound in the soft flesh around the nail.
  • They can be very painful and become infected.
  • There may be an overgrowth of tissue around the nail due to irritation of the wound.

How did I get this?

  • Direct trauma from tight footwear or stubbing your toe
  • Long term pressure from a thickened or curved toenail
  • Poor nail cutting leaving a sharp corner on the nail
  • Swollen toes and sweaty feet can weaken the skin around the nail.

What can I do about it?

  • Avoid footwear which presses on the toe.
  • Bathe the foot in salt water and apply an antiseptic dressing.
  • Trim the toenail as short as possible but do not cut into the painful side

What help can I get for this?

  • A podiatrist can remove the part of the nail that is causing the problem. This may be done under local anaesthetic if necessary.
  • A Podiatrist can advise on appropriate footwear and how to avoid further problems.
  • A doctor may prescribe antibiotics if the toe is infected, however the nail will still need treatment to prevent further infection
  • A Podiatrist can permanently remove the problem piece of nail and prevent regrowth. This procedure is performed under local anaesthetic and is a lasting solution

When will it get better?

  • Without treatment the nail will continue to grow and penetrate the wound.
  • Removal of the piece of nail provides immediate relief.
  • Careful nail care and the right shoes can prevent recurring problems

Ingrown toenail

Sesamoiditis – pain behind big toe

Summary

  • The sesamoids are two baked bean sized bones in the tendons under your big toe joint.
  • They can become inflamed and even fracture causing pain particularly when wakling quickly or running.

How did I get this?

  • Sesamoidits is usually seen in people who have a sharp blow to the joint, or have a high arched foot with a prominent big toe joint. Dancers and people that wear high heels are more prone to this.

What can I do about it?

  • Wear flat cushioning footwear such as joggers. Ice the area.
  • Short term use of anti inflammatory drugs such as ibuprofen may relieve the symptoms.

What help can I get for this?

  • See a podiatrist for footwear advice, padding, strapping, and possible orthotics to relieve stress on the sesamoids.
  • Immobilisation in a cam walker may be necessary for severe cases.
  • If there is a fracture that does not respond to conservative treatment then surgery may be necessary.

When will it get better?

  • Conservative measures should see improvement over a few months.
  • Surgical intervention will require a longer recovery period.

Hallux Valgus – Bunion

Summary

  • It is a deformity of the big toe joint, which pushes it towards smaller toes causing pain, inflammation, swelling, and stiffness around the joint, especially with pressure from tight shoes.

How did I get this?

  • Arthritis can be a risk factor.
  • Family history of Hallux Valgus.
  • Wearing tight shoes can contribute to the problem.

What can I do about it?

  • Wear good fitting shoes.
  • Avoid high heels.
  • Wear a pad over the bunion.
  • See a podiatrist.

What help can I get for this?

  • Podiatrist may advise on appropriate footwear, padding, night splints.
  • Podiatrist may consider prescribing orthotics.
  • Foot and ankle surgeon may advise on surgery if the joint is too painful.

When will it get better?

  • The symptoms may well settle, especially if you are careful with shoes, but the deformity is likely to progress.Surgery is the only effective way of correcting the deformity (but it may still reoccur in the future).

Hallux Limitus / Rigidus – stiff big toe

Summary

  • Hallux rigidus/limitusis a disorder of the joint (form of degenerative arthritis)located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe.

How did I get this?

  • History of trauma in the feet.
  • Faulty foot function.
  • History of arthritis.
  • Family history is a risk factor.

What can I do about it?

  • Rest from activities affecting the joint.
  • Stop wearing high heeled shoes.
  • Applying ice packs reduce inflammation for short period of time.
  • Contrast bath using alternating cold and hot water (30 seconds each for five minutes) to reduce inflammation.
  • Short term use of anti-inflammatory drugs such as ibuprofen to reduce pain and inflammation.

What help can I get for this?

  • A podiatrist may provide shoe modifications, padding, or orthoics.
  • An orthopaedic foot surgeon may assist with removing bony lumps or fusing the joint.

When will it get better?

  • It depends on severity, patient activity and expectation as well as the particular treatment used. Podiatry and activity modification can provide fast relief, along with appropriate footwear.

Turf Toe

Summary

  • It is simply a sprain of the ligaments around the big toe joint. It’s a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping. The most common symptoms of turf toe include pain, swelling, and limited joint movement at the base of one big toe. The symptoms develop slowly and gradually get worse over time if it’s caused by repetitive injury. If it’s caused by a sudden forceful motion, the injury can be painful immediately and worsen within 24 hours. Sometimes when the injury occurs, a “pop” can be felt. Usually the entire joint is involved, and toe movement is limited.

How did I get this?

  • The name “turf toe” comes from the fact that this injury is especially common among athletes who play on artificial turf. When playing sports on artificial turf the foot can stick to the hard surface, resulting in jamming of the big toe joint. There has also been some indication that less-supportive flexible shoes worn on artificial turf are also to blame.

What can I do about it?

  • Initial treatments include rest, ice, compression, and elevation. (RICE), as well as a change to less-flexible footwear.
  • Podiatry consultation for further management.

What help can I get for this?

  • Podiatrist may use measures to limit great toe motion such as stiff soled shoes, or a cam walker to protect the injured tissue while it heals.
  • Podiatrist may consider taping the big toe and using a Morton’s extension splint may be beneficial in protecting the toe.
  • Orthopaedic surgeon for surgical correction if nonoperative approach does not work with the symptoms.

When will it get better?

  • In many cases, if adequate compliance is achieved, conservatively and surgically treated patients can return to their preinjury level of function. However, some disability is possible with either form of treatment.

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