Do metal splinters come out on their own?
April 3, 2006 6:16 AM   Subscribe

Got a splinter (actually a metal whisker) in the sole of my foot. Can't get a hold of it without some significant flesh excavation. Will it get expelled eventually, or do I need medical attention?

About 3 days ago I was walking around barefoot and got that distinct "something is sticking in my foot twinge". Close inspection revealed a tiny metal whisker sticking out of my foot.

I grabbed it with a pair of tweezers and pulled. It started to come out, but then I feld a distinct "click" and only the portion actually grabbed by the tweezers came out. An hours worth of probing and digging with a needle and a knife point (both first wiped with rubbing alcohol) didn't expose any more of the whisker and was starting to produce plenty of blood.

So, here I am 3 days later. I know something is in there because I still feel that twinge constantly and a slight bit of pain when weighting that area. I can still walk fine, it's more annoying than anything else at this point.

Does something like this work itself out eventually or should I seek professional medial attention?
posted by de void to Health & Fitness (24 answers total)
Are you kidding? Of course this warrants medical attention, especially since you can't seem to remember whether you've ever had a tetanus shot.
posted by bilabial at 6:21 AM on April 3, 2006

I'm tempted to say just leave it in there, but there's always a chance of infection. The last thing you want on the sole of your foot is a swollen, pus-filled sack.

If you have good insurance and will only be out a reasonable co-pay, then have it extracted.
posted by pmbuko at 6:21 AM on April 3, 2006

For the record, I'm current on tetanus boosters.

(not sure how not mentioning that equates to "can't seem to remember", but there it is.)
posted by de void at 6:33 AM on April 3, 2006

Previously. But since this is metal, I'd think it's tetanus-shot time.
posted by booksandlibretti at 6:34 AM on April 3, 2006

Dammit. After following the tips in the other thread, I would still go to a doctor to make sure it's all out -- but that's just me.
posted by booksandlibretti at 6:35 AM on April 3, 2006

I've had some similar problems recently. The weights on my barbells at home are starting to flake - either metallic paint or poor chroming is coming off in small, extremely sharp flakes. Before I realized it, I had several of these flakes deposited beneath my skin in various places (eyelids, in front of my left ear, hands). These flakes were impossible for me to remove. I debated on going to the doctor, but didn't, and a couple of weeks later everything has cleared up without any real complications. IANAD, YMMV. How about calling your physician and asking him for some advice?
posted by syzygy at 6:54 AM on April 3, 2006

Tried a strong magnet? If it's a magnetic metal, that is.
posted by mikeh at 6:55 AM on April 3, 2006

since this is metal, I'd think it's tetanus-shot time.

Is this from the common idea that rusty nails are a bigger source of tetanus than, say, wood splinters? I've always been very skeptical about that. Anybody have definite knowledge?

If the metal is stainless steel or aluminum, you're probably going to have to get it excavated. If it's regular steel, it will rust away in time. If it was very thin, and lay on the ground for any length of time in a place that gets rain, it's probably not regular steel. It would have rusted away.

When I was a kid, we visited Lake Superior, and I went wading. I found a piece of broken glass with my foot and got cut fairly badly (stitches, etc). Months later, the cut had healed, but every time I stepped on that foot, I got a tingling. Went to the doctor, and he removed a piece of cartilage-like stuff that he said must have formed around a piece of grit (which he could not find). The "pearl" was pressing on a nerve when I stepped.
posted by Kirth Gerson at 7:01 AM on April 3, 2006

It should come out on its own eventually, but it might get infected (although that will actually help it come out). If it doesn't come out the body will wall it off, forming a foreign body granuloma. The only reason to take it out is for your comfort, but be aware that a physician may have no more luck digging it out than you did. The same thing happened to a nurse I work with (only it was a splinter of glass in her finger) and even after a trip to the OR it didn't come out and she ended up with a big bandage on her finger for a week.
posted by TedW at 7:08 AM on April 3, 2006

About 4 weeks ago I got a sliver of glass in my foot. It was tiny and impossible to see, let alone remove so I just left it, and everything seems to be fine. This was absolutely minute though - if the piece of metal in your foot is of any significant size I would get it seen to.
posted by fire&wings at 7:10 AM on April 3, 2006

On preview, Kirth is right that the rusty nail bit about tetanus is sort of an old wives tail. Here is a list of risk factors for tetanus. The real risk is from a deep wound that doesn't get exposed to air, as the tetanus bacterium is an anaerobeic bacteria. The gut is also a good place for anaerobes, which is why manure is a risk factor; thus, stepping on a nail in a barnyard is an injury that has some risk of transmitting tetanus, but in and of itself the nail is not the major risk.
posted by TedW at 7:12 AM on April 3, 2006

if it were in my hand, then I (personally) would stick some magnesium sulphate on it and wait to see what happened. The most likely answer is that either the mag-culph will draw it out, or the swarf will get surrounded with puss, and will expel itself.

However, this isn't in your hand - it's in your sodding foot. As soon as you add the element of sweaty bacteria breeding ground and the small matter of having to walk, I'd say get to a doctor or get to A&E / ER / whatever. Two years ago I managed to get a small shard of glass in the heel of my foot. It caused me a great deal of pain until I took it to A&E - where they excavated it in about ten minutes and sent me home again.
posted by twine42 at 7:21 AM on April 3, 2006

I'm pretty sure the rusty nail thing is not an old wives' tale. I trod on a big nail and the first thing my medical doctor friend said was, "Are you up to date on your tetanus jabs?" Admittedly, she is not a tetanusologist or or tetiatrician, but I would trust her, and any other doctor, over a site entitled Wrong Diagnosis.

posted by pollystark at 8:02 AM on April 3, 2006

I had a similar situation a short while back. I'm reasonably cowardly, but nonetheless I sterilized a nice fresh single-edge razor blade, sliced open my sole to the the necessary extent, and easily eased the splinter out. Relatively painless, and with antibiotic salve I healed up in a day or two.

This isn't necessarily advice, just another anecdotal data point. Digging at it with a knife, needle, and so forth was hopelessly ineffectual compared to the razor job, which took ten seconds. Also, from what I remember of high school microbiology ("RIP eater: he didn't remember high school microbiology quite right"), opening up the wound like that will aerate and bleed it enough to kill the oxygen-hating tetanus bacteria, which thrive in tight, airless deep puncture wounds rather than shallow lacerations.
posted by Eater at 8:18 AM on April 3, 2006

pollystark, are you saying that if you'd stepped on a big wooden splinter, that penetrated your foot to the same extent as the nail did, your doctor would not have asked about your shots?

Rust is just iron oxide, I can't see how it would serve as a better host for tetanus than a number of other common things. I'd speculate that the 'rusty nail' thing is because nails penetrate more deeply (as they are designed to), and and therefore may be more likely to introduce whatever's on them to the airless places TedW talks about.
posted by Kirth Gerson at 8:21 AM on April 3, 2006

I believe that the 'rusty nail' thing comes from what those nails were commonly used for - that is, horseshoes, so the nails were found commonly where horses were kept, and horses were a common vector for tetanus.

Horse drops a nail, it's in the dirt, tetanus is also in the dirt, then you step on the nail and drive infectious material deep into your flesh.

As for the original question, it doesn't sound like it's very serious, but I'd probably see about having it out.
posted by Dipsomaniac at 8:34 AM on April 3, 2006

-Derail danger! Derail danger!-

I've no idea what a doctor would say about a wooden splinter. I was simply passing on information that I got from a doctor about a similar situation and (slightly snidely, it's true) advising the poster and readers to not always accept what random websites say.
posted by pollystark at 8:37 AM on April 3, 2006

Kirth is exactly right about a splinter being as likely as a nail to lead to a tetanus infection, as evidenced by this website from the National Foundation for Infectious Diseases. I think this is only a semi-derail, as the original poster did say he was up to date on tetanus boosters, but readers in a similar situation who aren't up to date might need to get one.
posted by TedW at 8:43 AM on April 3, 2006

Tried a strong magnet? If it's a magnetic metal, that is.
posted by mikeh at 6:55 AM PST on April 3

Even if the splinter is ferrous, you'd need an incredibly strong magnet to pull something that small out of your flesh. Even a NdFeB wouldn't suffice; you'd be looking at an MRI machine, and I'm not even certain that would work.
posted by Optimus Chyme at 8:56 AM on April 3, 2006

If you're gonna have it dug out, seems better to do it now before your self-digging heals up. Otherwise it could be hard later to pinpoint where the splinter went in, making it tougher for the doc to find.
posted by Tubes at 9:43 AM on April 3, 2006

I'm a family physician and this comes up all the time.

1. The issue with tetanus is the break in the skin and how dirty the thing breaking the skin is. Nothing special about a rusty nail other than the fact that it is presumably exposed to the world and therefore may be contaminated. People who come in with road rash, spider bites, and kitchen knife injuries are all given shots.

2. You have only a few days to try and get this thing out, once scar tissue has set in, it is much more difficult to remove and it should be left alone.

3. The doctor is going to be in the same situation as you trying to get the thing out. We have forceps that are probably sharper than yours, but no special tools to "see" the object any better. We can however, give you a novacaine (xylocaine actually) shot that would allow us to dig around more, but honestly my experience has been that digging around with a scalpel doesn't seem to improve the odds of finding it.

4. Evetually the body will absorb the material, or expel it. Is the pain you're experiencing now due to the presence of the splinter or is it because you were digging around in there?

9 times out of 10, the patient and I decide to give a tetanus booster, a band aid, and leave it at that.
posted by Slarty Bartfast at 9:43 AM on April 3, 2006 [2 favorites]

You can't avoid putting weight on your foot, so I vote have it looked at - weight on the foot to me would mean it's getting pushed further up there, not having much chance to work itself out.
posted by agregoli at 10:41 AM on April 3, 2006

Do metal splinters come out on their own? It probably depends on how deep the splinter is. Have you read stories about soldiers and "collateral damage" civilians carrying around metal shrapnel for years and years? Same idea.

Would you prefer a story closer to your own that involves accidental introduction of a metal pointy thing in a foot? Can do. My wife had knee surgery when she was a teen [mumble] years ago. The operation screwed up some of the nerves going to her foot, and as a consequence she could experience unsourced pain or numbness there. She also used to sew a lot, and needles would occasionally fall to the floor unnoticed. See where this is going? Seven years ago she went in for an x-ray of her foot because it was hurting her. Doctor says "by the way, do you know you have a needle in your foot?". Just a side amusement for him and her, it wasn't what was causing the pain. The doctor said it was best to leave it in there since it wasn't hurting anything. As near as they can tell, the needle has been in there for at least twenty years. It remains in there to this day.

As proof, and because everyone in the world loves to bore everyone else with their pictures and I am no exception, here's an x-ray of aforementioned wife-foot with the pin highlighted:

posted by mdevore at 11:54 AM on April 3, 2006

I should reveal that my comments concerning what metal de void's splinter might be were groundedi n some other personal experience. I used to be a machinist, and getting metal splinters in my hands was not uncommon. If I'd been cutting steel, I didn't worry too much if I couldn't get the splinter out, since it would eventually disappear. Stainless was another story - it wouldn't disappear, and it would sometimes work its way deeper over time. I always did whatever it took to get the stainless slivers out.
posted by Kirth Gerson at 12:26 PM on April 3, 2006

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