Any hope out there?

April 11, 2011 11:04 AM

About a decade ago, I stubbed my big toe so badly that I clearly broke it. My crappy University Health Services refused to x-ray it, insisting that it was just a normal stub. I have since had severe pain every step I take, I can't really bend it very well, it sits differently than the other toe, and I am incapable of wearing heels or doing various athletic activities that I am dying to do, or even wearing most flat shoes, or taking long walks. I fantasize about it being broken again and then set correctly, but I have no idea if this is something that is done. What do doctors tend to do in this kind of situation, so I have some idea before trying to arrange a way to see someone?

I know you are not my doctor, etc., but if you have any insight into typical treatments or surgery I would really appreciate some sense of whether there is hope, or if toes are just too finicky to address in a helpful way. Many thanks for any input.

posted by asimplemouse to health & fitness (14 answers total)

You need to see a doctor, preferably an orthopedist. There are treatments for mishealed breaks, and such a doctor can tell you which treatments might be appropriate for you.
posted by decathecting at 11:18 AM on April 11, 2011

I don't know, but the order of things I'd try is to: see if your insurance covers visiting a different hospital, insist harder with University Health Services (ideally someone you didn't talk to the first time) to see a qualified doctor and get an x-ray (how hard did you push? for severe pain and sitting differently it seems like commonsense to x-ray), and see if suing for malpractice is a good idea (assuming you're in America and don't mind spending time with lawyers). I'm sorry you're going through this. Good luck!
posted by sninctown at 11:28 AM on April 11, 2011

I have broken many toes. Only once was one "re-set" (and that was a "compound dislocation" - don't ask). In general, all that has been done is to "buddy tape" the toe to its neighbor, told to take asprin/advil/tylenol, ice it, and told me to stay off it. The only ill effect I've noticed is that a couple of my toes are oddly shaped.
posted by ObscureReferenceMan at 11:30 AM on April 11, 2011 [2 favorites]

Toes re not too finicky to address in a helpful way! Were it me, I'd start out seeing a local podiatrist. Assuming you are in the US, this person should be highly qualified to asses you and make recommendation for treatment, including an ortho consult if needed.
posted by DarlingBri at 11:42 AM on April 11, 2011

You've had debilitating pain for a decade?! If so, icing it and taking pain meds won't solve your problem, and surgery will likely be the only option.
posted by you're a kitty! at 11:46 AM on April 11, 2011

Um, I said this happened a decade ago, so the suggestion to push harder with Health Services are impossible. I'm not sure why the answer regarding 'buddy taping' my toes was favorited twice. This is an out-the-ordinary thing and I really damaged myself... to the point that I have spent a decade in pain while without health insurance. I'm hoping for information about more than simply broken toes that remain a funny shape. Well, thanks for the answers so far, and I am still hoping someone might chime in with experience or stories or anything regarding fixing a severely badly-healed break in the big toe. Many thanks.
posted by asimplemouse at 12:31 PM on April 11, 2011

Also, the problem is that I don't have health insurance. I just wanted to make sure there might be some hope before I try to navigate these pricey medical waters. I finally feel like I am at my limit with this chronic pain, and was just looking for a a little more anecdotal information about what might be possible as far as theoretical treatments. Thanks!
posted by asimplemouse at 12:35 PM on April 11, 2011

Really, go see an orthopedist. They will be able to tell you what options are available (break and reset, surgery, etc) and start you down the road to fixing this if it's at all possible.
posted by The Michael The at 12:36 PM on April 11, 2011

I think you should start with a podiatrist. There may be other solutions, like a custom-made orthotic that will support your toe or the big toe joint. There may be treatments, such as cortisone injections, that might help. Ask friends if they know a good podiatrist in your area, otherwise start calling around and asking each office if they do any pro bono work for the uninsured, or if they offer lower rates or other specials.

If you can find a community health fair in your area, that may also be a starting point. They sometimes offer consultations, x-rays and other services for free or at sharply discounted rates.
posted by BlahLaLa at 12:39 PM on April 11, 2011 [1 favorite]

You have severe pain every step you take. This is not something to screw around with. Go see someone right away. It's hard to afford medical care, but can you afford to be literally unable to walk for the rest of your life? Be up front with them that you don't have insurance (what happened to the insurance you got in this question?) and ask for referrals to low-cost clinics or physicians who offer discounted rates for the uninsured. No one here can diagnose you or give possible treatments without examining you and probably looking at x-rays, but pain, especially severe pain, is a sign that something is wrong with your body, and you really need to deal with it properly before it causes further damage. If you've been walking funny because of your toe, you could easily damage other parts of your feet, legs, or hips as a result.
posted by zachlipton at 12:58 PM on April 11, 2011

IANAL & IANAD, but if the University Health Service really did such a terrible job with treating the broken toe that a decade later you still have excruciating pain, maybe you should look into your legal options. Might help pay for the services you need now.
posted by epersonae at 1:29 PM on April 11, 2011 [1 favorite]

I once broke my little toe, went to the ER because it looked worse than previous instances (I'd broken toes before), and they did the usual "here's a band-aid get outa here" thing. A week later I was still in more pain than normal, went to my primary care physician who took a quick look and referred me to an orthopedist. Said orthopedist x-rayed the foot, then proceeded to re-break the toe followed by a more aggressive version of buddy taping. The act of re-breaking the toe hurt like an 8 but felt better within an hour.
posted by Runes at 1:32 PM on April 11, 2011

I wouldn't suggest starting with a podiatrist, because they've not been to med school. I love my podiatrist, but you should go to a doctor. Find an orthopedist.
posted by monkeymonkey at 2:14 PM on April 11, 2011

*raises hand*

Been there, done that, got the toe plate to prove it.

After years of dealing with constant low-level pain from a broken left big toe resulting from a severe stubbing and break, (like yours) finally a draft horse stomped down on that same toe, so I had to go in to have something done. It was a wee bit beyond buddy taping. My orthopedist removed several floating fragments and plated the toe to immobilize the damaged-beyond-repair joint. Because the joint would longer be mobile, and that would impair my gait, he also cut tendons in the back of my leg to allow my heel to flex down to compensate while walking.

The operation completely took care of all pain. The plated toe healed within six weeks, but I was totally off that leg on a knee scooter for three months till the tendons healed. (Since then, I've been told by another doctor that it isn't always necessary to operate on the tendons, but it's water under the bridge at this point.)

About a month after I started walking, I developed an ingrown toenail on that foot. The pain was worse than when the horse stomped on it!! It was sheer agony until it healed. It's only happened the once, and now I'm very careful about how I cut my toenails and take care of the cuticle.

My two complaints about having the plate: the toe angle has changed so that it rubs against my second toe causing blisters when I hike, and the plate has affected my foot width, making wide shoes an absolute necessity.

My 2 cents is go get something done. Skip the podiatrist, see an orthopedist. You're beyond cortisone injections at this point, and if you're like me, your gait has altered to the point you're causing joint problems in your knees* and hips, and this may well be affecting your back. Orthotics may be a band-aid solution for the short term, but they won't help in the long run, and you can spend lots of money on custom-made orthotics that don't do crap.

*Thanks, in part, to compensation for the years of walking funny, I just had a right knee replacement this winter. Looking to replace the left knee in a few years. The sooner you take care of this toe, the better off you'll be and the fewer problems you'll have in the long run.
posted by BlueHorse at 8:39 PM on April 11, 2011