I'm Slow Due to a Blow to my Toe. Doh!
April 11, 2012 8:44 PM   Subscribe

Toe injury advice requested from people who are not my doctor.

I was involved in a car accident this afternoon, and I injured my toe. It didn't hurt at all til an hour or two later. But now it hurts quite badly. It's moderately swollen (lower-half and just behind the tow, maybe an inch) and it has a small bruise on top. I'm keeping it iced and elevated (both at the same time is hard, so I alternate). It really hurts to walk on it, so I'm trying not to do that. No other part of my foot hurts, other toes, ankle, anything. Though walking is moderately agonizing. I can move the toe, though it hurts.

Do you think it's tweaked, sprained, broken? Am I taken proper care of it so far? What should I do tomorrow? Go to a clinic? Urgent care? Hospital? I have no health insurance, and now limited mobility, so I want to go to the right place first. Or preferably not at all if this will heal on it's own. ::Fingers Crossed::

You are not my doctor. Advice is appreciated anyway and will be taken with a grain of salt (and a painkiller). Thank you.
posted by Garm to Health & Fitness (20 answers total) 1 user marked this as a favorite
It sounds like the sort of thing I would apply RICE (rest, ice, compression, elevation) to at most and leave it at that (and I get free healthcare, FWIW). You know, grit my teeth, say 'no, really, I'm fine' to anyone that asks and get on with things.
posted by dg at 8:48 PM on April 11, 2012

I have no idea what's going on with your toe. But, if it is broken, all that they can do is confirm that it's broken and tape it to the toe next to it to immobilize it so it can heal. So, a doctor's visit might not be worth the money for you.

The internet says to go to the ER immediately if your toe goes numb or gray.
posted by insectosaurus at 8:51 PM on April 11, 2012

FWIW, I injured my toe in a flip-flop accident (LOL) a few years back, and when I went to my doctor she said she could send me for an x-ray to see if it was broken, but that would pointless since because the treatment was the same whether it was broken or just bruised. So, keep doing what you're doing, and once the swelling goes down, tape it to one of its neighbor toes as a kind of splint.
posted by Joh at 8:51 PM on April 11, 2012

You didn't specify which toe, but unless it is your big toe, then what people are saying is correct or at least that's also been my experience. However i have known people who've broken their big toe and had to get a full on cast.
posted by kaybdc at 9:22 PM on April 11, 2012

I broke a toe, and when I did it it hurt immediately and in a very special way (I'd never broken anything before). I had health insurance so I did go to the doctor, and the only things I got were a) confirmation that it was broken, and b) pain medication (which was kind of worth it, tbh).

So as totally not your, or a, doctor, I'm guessing it's probably not broken, and is more tweaked/smashed/sprained. The suggestion of RICE is good. Also if you have a bike, I found biking was less painful than walking for a while because you can put all the pressure on your heel.
posted by grapesaresour at 9:25 PM on April 11, 2012

It sounds broken to me. If it's just your toe, the free moving part, you don't have to go to a doctor. If it's the bit that attaches to your foot you really should though to make sure it heals up. Also you might need to immobilize that.
posted by fshgrl at 9:37 PM on April 11, 2012

You also might have damaged a ligament or tendon and they'll likely stick you in an air cast for a few weeks if you have.
posted by fshgrl at 9:39 PM on April 11, 2012

See how it feels tomorrow. I had a broken toe, at the ER they taped it and said I should tape it for a couple weeks. I felt dumb for going to the ER but it hurt like heck. Now I know better.

So, anecdotal evidence, but keep a close eye on it.
posted by manicure12 at 10:24 PM on April 11, 2012

Best answer: Many foot injuries heal well on their own, but others will heal better and faster with proper medical care. Could be a break, could be soft tissue damage. It's soft tissue damage that can be a bitch, taking longer to heal fully than many breaks.

1) Avoid walking, stair climbing, and toe wiggling tonight and tomorrow morning, and longer if it continues to hurt. If you live in a 2 story apartment or house, try to set yourself up to live on the main floor.

2) Stay in bed as much as possible with your foot elevated above your heart. Ice it for no longer than 20 minutes at a time several times a day. Remember not to apply ice to bare skin: ice cubes in a baggie, or a cold pack laid over thin cloth, will help protect your skin.

3) Compression? Avoid it. I've found that it just made things more painful.

4) Take an anti-inflammatory like Advil for a couple of days to reduce inflammation. Don't exceed the recommended dose.

5) If you want to try taping your toe, this video may help. If the strain, sprain actually in the metatarsals (the long bones in the forefoot below your toes), taping probably won't help much. or break is

6) You should go to the ER IMMEDIATELY if it goes grey or numb, but otherwise, what you're looking for is steady improvement. If you're resting, icing, elevating and walking as little as possible, you will probably find you will be walking more easily by the weekend. If you don't improve and walking stays moderately agonizing, or if it gets worse, then you should see a doctor. A sports medicine clinic with x-ray facilities would be ideal, but an ER or walk-in clinic may work, too.
posted by maudlin at 10:44 PM on April 11, 2012

I'd watch out for the following:

- Swelling should start to go down after 24-48 hours
- Circulation, sensation, and movement (CSM) should be approaching normal or at least getting better after 24-48 hours

In the meantime, RICE it and splint it. Check CSM often, and go to urgent care or the ER if things get dramatically worse. If it's OK but not getting better by Friday/Saturday, I would have urgent care take a look at it.

What's the deal with the accident? Will you be able to make medical claims on someone else's insurance?
posted by cosmologinaut at 10:45 PM on April 11, 2012

So there's breaking a toe, and then there's breaking your foot bones as a result of inappropriate force on your toe. One involves some tape, the other involves a boot/aircast, surgery, or some other thing you can't do with tape.

If you have a digital camera or cameraphone, put something next to or behind your foot for scale and then take a couple of shots (get one side-on if you can put the foot up in your lap, or have someone else do it) before you go to bed. Do it again every 12 hours, or more frequently if you think something's changing. That way you can objectively decide if it's trending toward worse or better, and if you do end up hobbling into the ER/UC/Doctor in a couple of days you can pretty effectively tell the story of what's been going on.

And, of course, what everyone else said about circulation.
posted by Lyn Never at 10:53 PM on April 11, 2012 [1 favorite]

Yeah, a broken toe gets taped to its neighbor to encourage it to set right and you do the RICE thing. If its the big toe you might worry more, or if anything's at an odd angle. But if its bruising and swelling, they'll tell you to rest it and ice it and tape it to a buddy, and most places won't Xray because it doesn't change the treatment.

A doctor cam offer you better painkillers, however, if the pain remains excruciating.
posted by Eyebrows McGee at 10:54 PM on April 11, 2012

I sprained my ankle recently, and there was still a lot of OW OW OW pain after waiting 24 hours and trying to stand up with a little weight. I went to urgent care and found out that my ankle was a-o-k, but two of my toes had significant fractures in them

So: urgent care or ER. I heard some patients go through urgent care who didn't have insurance, and they had to pay $150. Please get this taken care of. I'm so sorry you had to go through the accident. :(
posted by mild deer at 11:56 PM on April 11, 2012

IANYD. I agree with others about the 'buddy taping' of broken toes. However, I noted the key point you made in your story: it didn't hurt at all for the first two hours. It is unlikely to be broken simply based on that fact. Broken bones hurt. It is more likely to be sprained and now painful because it is swelling and bruising.

You can alternate Tylenol and ibuprofen if you're trying to avoid needing stronger pain meds, in addition to the RICE-ing.
posted by treehorn+bunny at 11:57 PM on April 11, 2012 [1 favorite]

btw, I would not go to the ER for this because they will charge you a million dollars. Find an urgent care that has an xray or some kind of clinic with that capacity so they can determine if it's broken for you. Or call an old GP and ask them to take a look.

If it's serious the car insurance should pay for it so don't let that stop you from pursuing treatment if they tell you you need it. Only have one set of toes etc etc
posted by fshgrl at 12:16 AM on April 12, 2012

Do you have a bruise under the nail? You might then have a subungual hematoma and if so it might feel better if you drain it!
posted by v-tach at 1:53 AM on April 12, 2012

As for the difficulty with elevation and ice . . .
If you have access to some marbles or bearing balls (stone or metal only, not glass), you can try freezing them overnight then sticking them to some tape or putting them in a plastic bag.
posted by jaimystery at 4:04 AM on April 12, 2012

Oh needless to say, don't put the marbles directly on your skin. Especially the metal ones.
posted by jaimystery at 4:05 AM on April 12, 2012

I broke three toes (the three smallest) in a car accident several years ago, and they weren't even able to confirm that they were broken by x-ray (something about too much swelling). They turned interesting colors in the purple side of the spectrum.

The attending doctor just told me to make sure I didn't lose feeling in them at any time, and to come in immediately if i lost feeling or if they turned white/gray. I ended up taking ibuprofin for the pain, icing them when i could. I sometimes wrapped them, but I wasn't very good at it and my toes are small, so for the most part, I just stayed off my feet.
posted by Verdandi at 5:32 AM on April 12, 2012

Response by poster: Thanks for all the advice. It's looking more bruised and swollen now, but it's not numb or grey, so no doctors for me. It's not so much the toe that is swollen and bruised, but right behind it. It doesn't hurt at all unless I poke it or try to walk on it, so I have a cane for that (walking, not poking). Doing the RICE thing (well, minus compression, so IRE?). If it isn't looking noticeably better Monday, I'll go to the clinic. I really appreciate everybody who took the time to tell me not to panic and when it would be useful to panic.
posted by Garm at 8:34 PM on April 12, 2012

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