Stubbed Toe or Jammed Toe? What to Do Now and When to See a Foot Doctor
Dr. J. Adrian Wright
Almost everyone has stubbed a toe on a coffee table or bedpost. Most of these injuries are painful but heal at home. Some, though, are fractures, joint injuries, or nail problems that heal poorly without care. Here is how to tell the difference.
Stubbed Toe: What to do right away
Stop and get off the foot. Sit down and take the weight off it.
Ice it. Apply a cold pack wrapped in a thin towel for 15 to 20 minutes at a time, several times a day for the first couple of days. Never put ice directly on the skin.
Elevate the foot above heart level when you can. This reduces swelling.
Protect the toe. Wear a stiff-soled, roomy shoe or sandal, and avoid tight shoes that squeeze it.
Use over-the-counter pain relief only as directed on the label and only if it's safe for you. Check with your doctor if you have kidney, stomach, or heart problems or take blood thinners.
"Buddy taping"
For a suspected injury to one of the smaller toes, you can tape it to the toe next to it, with a small piece of gauze or cotton between them to prevent skin irritation. This gives gentle support. Don't tape tightly enough to cause throbbing, color change, or numbness. Remove the tape if any of those occur. A big toe injury, or any toe that looks crooked, should be examined before you tape it.
Is it broken? You can't tell at home
A common myth is that if you can wiggle the toe, it isn't broken. That's false. People walk on broken toes every day. Bruising, swelling, and pain can look the same in a toe that is not broken and one that is. Only a medical exam and an X-ray can tell them apart.
When to make an appointment
Call a podiatrist or foot and ankle specialist if you notice any of the following:
The toe looks bent, crooked, or out of position
Pain is severe, or you can't walk normally on the foot
Swelling or bruising is spreading, or is getting worse after 48 hours
Pain isn't clearly improving after a week or so
The big toe is hurt, since it carries much of your body weight
The injury happened during sports, or the joint at the base of the toe is painful or stiff (this may be a "turf toe" sprain)
There is blood under the toenail, or the nail is lifted, torn, or cracked at the base
You have diabetes, neuropathy, poor circulation, are on blood thinners, or have a weakened immune system. For these patients, even a minor foot injury should be checked promptly.
When it's urgent: same day or the emergency room
Seek care right away if there is:
Bone visible or a deep, open wound
A toe that is cold, pale, blue, or numb
Signs of infection: spreading redness, warmth, pus, red streaks, or fever
Severe pain with a clear deformity
Blood under the toenail
A dark bruise under the nail (a subungual hematoma) is common after a jam or a drop. If it is very painful from pressure, or covers a large part of the nail, you should book an appointment as soon as possible as this could suggest a nail bed laceration. Releasing the pressure is a quick in-office step, and it also lets the doctor check for a fracture underneath. Don't try to drain it yourself, because that can lead to infection. A nail that turns black may fall off over weeks to months, and a new nail grows in slowly. Watch for redness, drainage, or increasing pain as it heals. We recommend an office visit / medical evaluation for anytime a patient has a suspected nail bed laceration.
What recovery usually looks like
Recovery depends on the injury, and a doctor's exam is the only way to know which one you have. As a general guide:
A bruised or sprained toe often improves in one to two weeks.
A broken smaller toe commonly takes about four to six weeks.
A broken big toe or a joint injury can take longer, and some may need more than taping or a protective shoe.
Preventing the next one
Wear shoes or slippers in the house, especially at night.
Clear cords, furniture edges, and clutter from walkways, and use night lights.
Choose supportive shoes with a protective toe box for sports and work.
When in doubt, get it checked
A toe that heals crooked or stays painful and stiff is much easier to address early than months later. If you're not sure whether your injury is serious, an exam is the quickest way to find out. To schedule a visit, call us: 201-571-0900, or click HERE to request an appointment.
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