Is it a sprain or a break?
If you’ve ever stubbed your toe hard, the immediate, severe pain can leave you wondering if your toe is broken. In many cases, the injury winds up being a sprain. This is painful, but it means the bone itself is still intact. If the toe bone breaks into one or more pieces, then you have a broken toe.
Learning to recognize the symptoms and treatment of a broken toe is important. If a broken toe is left untreated, it can lead to problems that may affect your ability to walk and run. A poorly treated broken toe may also leave you in a lot of pain.
Throbbing pain in the toe is the first sign that it may be broken. You may also hear the bone break at the time of injury. A broken bone, also called a fracture, may also cause swelling at the break. If you’ve broken your toe, the skin near the injury may looked bruised or temporarily change color. You’ll also have difficulty putting any weight on your toe. Walking, or even just standing, can be painful. A bad break can also dislocate the toe, which can cause it to rest at an unnatural angle.
A sprained toe shouldn’t look dislocated. It will still swell, but will likely have less bruising. A sprained toe may be painful for several days, but should then begin to improve. One other key difference between a break and a sprain is the location of the pain. Usually a break will hurt right where the bone has fractured. With a sprain, the pain may be felt in a more general area around the toe.
The only way to tell for sure if the injury is a break or a sprain is to see your doctor. They can examine your toe and determine the type of injury.
The two most common causes of a broken toe are stubbing it into something hard or having something heavy land on it. Going barefoot is a major risk factor, especially if you’re walking in the dark or in an unfamiliar environment. If you carry heavy objects without proper foot protection, such as thick boots, you’re also at a higher risk for a broken toe.
What to expect when you see your doctor
A broken toe can usually be diagnosed with the use of an X-ray. If the pain and discoloration don’t ease up after a few days, you should definitely see your doctor. A broken toe that doesn’t heal properly could lead to osteoarthritis, a painful condition that causes chronic pain in one or more joints.
Your doctor will examine your toe and ask for your medical history. Tell your doctor as many details as you can about the injury and your symptoms. Be sure to tell your doctor if you notice a loss of feeling or tingling in your toe. This could be a sign of nerve damage.
If there’s a chance the toe is broken, your doctor will likely want to get one or more X-rays of the injured toe. Getting images from different angles is important to understand the extent of the break. Information from the X-ray will also help your doctor decide whether surgery is necessary.
With most cases of a broken toe, there’s little your doctor can do. It’s mostly up to you to rest your toe and keep it stable.
Even before you know whether or not your toe is broken, you should ice the injured toe and keep it elevated. You may also take over-the-counter painkillers, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). If you have surgery to repair the toe, your doctor may prescribe stronger pain medicines.
Splinting your toe
Typical treatment for a broken toe is called “buddy taping.” This involves taking the broken toe and carefully securing it to the toe next to it with medical tape. Usually, a gauze pad is placed between the toes to prevent skin irritation. The non-broken toe is basically used as a splint to help keep the broken toe from moving too much. By taping the broken toe to its neighbor, you give the injured toe the support it needs to begin healing.
Surgery and additional treatment options
More serious breaks may require additional treatment. If you have bone fragments in the toe that need to heal, taping may not be enough. You may be advised to wear a walking cast. This helps keep the injured toe stable while also giving your foot enough support to reduce some of the pain you may have while walking.
In very serious cases, surgery may be necessary to reset the broken bone or bones. A surgeon can sometimes put a pin or a screw into the bone to help it heal properly. These pieces of hardware will remain in the toe permanently.
Your toe is likely to be tender and swollen, even after a few weeks. You’ll likely need to avoid running, playing sports, or walking long distances for one to two months after your injury. Recovery time can be longer if the break is in one of the metatarsals. The metatarsals are the longer bones in the foot that connect to the phalanges, which are the smaller bones in the toes.
Your doctor can give you a good estimate of recovery time based on the severity and location of your injury. A mild fracture, for example, should heal faster than a more severe break.
With a walking cast, you should be able to walk and resume most non-strenuous activities within a week or two after injuring your toe. The pain should diminish gradually if the bone is healing properly. If you feel any pain in your broken toe, stop the activity that’s causing the pain and tell your doctor.
The key to a good outcome is following through on your doctor’s advice. Learn how to tape your toe properly so you can change the tape regularly. Carefully try to put more pressure on your broken toe each day to see how it’s recovering. Take any slight improvements in pain and discomfort as signs that your injury is healing.
Tips for recovery
Here are some things you can do to improve your recovery.
You may temporarily need a bigger or wider shoe to accommodate your swollen foot. Consider getting a shoe with a hard sole and a lightweight top that will put less pressure on the injured toe, but still provide plenty of support. Velcro fasteners that you can easily adjust can provide additional comfort.
Ice and elevation
Continue to ice and elevate your foot if your doctor recommends it. Wrap the ice in a cloth so that it doesn’t come into direct contact with your skin.
Take it slow
Ease back into your activities, but listen to your body. If you sense that you’re putting too much weight or stress on the toe, back off. It’s better to have a longer recovery and avoid any painful setbacks than to rush back into your activities too quickly.