Tag Archives: 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.

Interdigital Hyperkeratosis – Soft Corns

Summary

  • Painful thick skin between the toes.
  • Sometimes very hard and dry
  • Sometimes the thick skin is soft, white and macerated (soft corn)
  • There may also be a fungal infection
  • The worst cases may blister and form a wound.

How did I get this?

  • Increased pressure between your toes possibly caused by any or all of the following: tight shoes, bony lumps, enlarged joints, thick toenails.

What can I do about it?

  • Wear shoes with a deep wide toebox
  • Wear a pad between the toes
  • Trim your toenails carefully
  • Treat fungal infections

What help can I get for this?

  • Podiatrist will gently remove the thick skin
  • Podiatrists can provide made to measure pads for between your toes
  • Shoe store can fit your shoes carefully
  • Surgeons can straighten toes and remove bony lumps

When will it get better?

  • Removal of the thick skin can provide immediate relief
  • Padding between the toes can help prevent recurring problem.

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

Nerve entrapment / Neuroma

Summary

  • Thickening of the tissue that surrounds the nerve leading to the toes. Burning pain in the ball of the foot that may goes into the toes which generally intensifies with activity or wearing shoes. There may also be numbness or an unpleasant feeling in the toes.

How did I get this?

  • Anything that causes compression or irritation of the nerve can lead to the development of a neuroma (e.g. wearing high healed or tight shoes). Foot deformities are risk factors. Injury and trauma to the feet can also lead to this condition.

What can I do about it?

  • Placing an icepack on the affected area helps reduce swelling.
  • Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
  • Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
  • Padding techniques provide support lessening the pressure on the nerve and decreasing the compression when walking.

What help can I get for this?

    • Podiatry consultation for treatments that include footwear advice, padding, orthotics, and may advise guided injections for alleviating the pain.
    • Surgery may be considered if not responded adequately to non-surgical treatments.

When will it get better?

  • Appropriate treatment can provide swift relief, but you will still need to consider long-term measures to help keep your symptoms from returning.

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Plantar Plate tear/rupture – pain under toes

Summary

  • The plantar plate is a thick ligament on the underside of your foot, running along the first joint of each toe. Its purpose is to act like a support cable and protect the toe joints from pressure and injury, and to prevent the joint from bending upward beyond the normal range of motion. Injury to the plantar plate results to mild to severe pain and swelling under the ball of the foot, extending toward the toes (most commonly the 2nd or 3rd). One or more of your toes may be splayed or clawed. You may also have a sensation of numbness or “burning pain” in your toes, or a feeling like you’re walking on the bones of your foot.

How did I get this?

  • Injury to the plantar plate is usually caused by overuse, such as from running; obesity, which puts too much body weight on the ligament; or wearing high heeled shoes too often which locks the forefoot into a flexed position and requires the plantar plate to carry all of your body weight.

What can I do about it?

  • Icing the injured area.
  • Short term anti inflammatory medications (e.g. ibuprofen) to reduce pain and inflammation.
  • Seek podiatry consultation.

What help can I get for this?

  • Podiatrist may prescribe strapping the toe into a downward position to align it in order to help healing, footwear modifications, orthotics.
  • Podiatrist prescribe special boot or shoe if your case is severe to keep weight completely off the ball of your foot.
  • Foot and ankle surgeon for surgical treatment when non-surgical measures fail to alleviate pain and begin to limit your lifestyle.

When will it get better?

  • Treatment for this acute condition can take time, with most patients pain free with 3-4 months. Initial symptoms improvement allows most people to return to activity within 1 month.

Intermetatarsal Bursitis – toe pain

Summary

  • A bursa is a fluid-filled cushioning sac. They are located near tendons, ligaments, skin, and muscles that would otherwise rub directly across the surface of a bone. They are very important to prevent friction, absorb shock, and decrease the wear and tear between moving structures. The intermetatarsal bursae are located on the bottom of the foot near the base of the toes. They can be irritated when one metatarsal bone takes more load than the others. When this happens, the soft tissue between the bone and the skin becomes compressed and inflammation in the bursa can begin. Walking barefoot on a hardwood or tiled floor without cushioning will increase pain noticeably due to the direct pressure on the metatarsal bursa.

How did I get this?

  • It is commonly due to strain or irritation of the bursa. Wearing narrow or excessively worn footwear throughout the day or while playing sports also increase your chance of bursitis developing in your feet and toes.

What can I do about it?

  • Anti-inflammatory tablets (e.g. Ibuprofen) can help although should not be taken for long periods without professional advice.
  • Hot or cold ice packs can help symptoms to improve.
  • Rest the foot.
  • Perform stretching exercises to improve joint motion.
  • Wear good fitting shoes.
  • Avoid high heels.
  • Wear a protective pad.
  • See a podiatrist.

What help can I get for this?

  • Podiatrists may advise appropriate shoes or add padding to your existing shoes, consider prescribing orthotics, advise taping / strapping.
  • Your Doctor may administer a cortisone injection to reduce inflammation if indicated, and possibly suggest surgical management.

When will it get better?

  • Conservative treatments may be sufficient to resolve symptoms and prevent recurrence. However, if the bursitis becomes chronic surgery may be necessary.

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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Stress Fracture

Summary

  • Stress Fracture occurs when excessive repetitive force is applied to a localized area of bone. Activities such as walking, running, and repeated jumping can subject the bones of the foot to large forces that often lead to microscopic cracks in the bone.

How did I get this?

  • Generally, it is repetitive stress (i.e. running, marching, sport etc.) although some bone diseases can pre-dispose to thin bones which therefore fracture more easily. In people with osteoporosis (thinning of the bone) there is an increased risk of stress fracture.

What can I do about it?

  • Rest the area and stop sporting activity.
  • Wear good fitting shoes with adequate support and cushioning.
  • Avoid high heels.
  • You can try a protective pad.
  • See a podiatrist.

What help can I get for this?

  • Podiatrist may advise appropriate shoes, consider prescribing orthotics, consider immobilisation, and advise on surgery.

When will it get better?

  • In the majority of cases, conservative care allows the bone to heal and normal activity can then be resumed. Surgery is sometimes necessary to stabilise the fracture site which allows longer time to resume activity.

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Nerve entrapment – Neuroma

Summary

  • Nerve entrapment – Neuroma is caused by thickening of the tissue that surrounds the nerve leading to the toes. Burning pain in the ball of the foot that may goes into the toes which generally intensifies with activity or wearing shoes. There may also be numbness or an unpleasant feeling in the toes.

How did I get this?

  • Anything that causes compression or irritation of the nerve can lead to the development of a neuroma (e.g. wearing high heeled or tight shoes). Foot deformities are risk factors. Injury and trauma to the feet can also lead to this condition.

What can I do about it?

  • Placing an icepack on the affected area helps reduce swelling.
  • Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
  • Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
  • Padding techniques provide support lessening the pressure on the nerve and decreasing the compression when walking.

What help can I get for this?

    • Podiatry consultation for treatments that include footwear advice, padding, orthotics, and may advise guided injections for alleviating the pain.
    • Surgery may be considered if not responded adequately to non-surgical treatments.

When will it get better?

  • Appropriate treatment can provide swift relief, but you will still need to consider long-term measures to help keep your symptoms from returning.