Extreme sharp pain in my big toe

by Darren
(Arnhem, Netherlands)

Quite simple cause really.

In November, I stepped on a drawing pin which went all the way into my big toe. I immediately pulled it out (no blood) and went to bed (was hurting). Over the next week it hurt when I put my full weight on it but eventually the pain went away.

NO HERES THE STRANGE BIT.

Now and then when I walk on it again I get EXACTLY the same pain as if I am stepping on it again?! The pain goes away quickly but just for a few moments it is extremely painful (sharp). There is no sign of infection or anything?

I am an ex semi-pro rugby player so I know what pain is, so I am not making a mountain out of a mole hill, as they say.

It is now February and completely bemused why I am still getting this?

I have had Tetnus and apart from some funghi on my feet everything else is fine.

Best Regards

Darren

RESPONSE

Hi Darren,

Strange things happen all the time but I am not so sure this is one of them. Evidently, when you stepped on the pin, it did some damage to a structure in your toe.
I will assume the pin went into the bottom of your toe (you stepped on it) and if that is the case and if the pin entered exactly in the middle portion of the bottom of the toe, then my first thought would be that you may have done some damage to the flexor tendon, which is the tendon that allows you to bend your toe downward.
If the pin insertion was off center then the pin may have hit the bone.
If the pin insertion was more to the outside of the toe then there is always the possibility that the pin hit was is known as one of the proper digital nerves, which are nerves that go into the toe and give you sensation in the toe.
So, now the question becomes how much force was exerted when the pin went through the skin and "stuck" whatever structure it hit.
The point of all this is that you probably aggravated something just enough that it flares up from time to time and when it does flare up it hurts for a short period of time.
Without having the luxury of being able to see where the pain actually went into your toe, it is impossible for me to be any more specific.
Now you certainly could visit a local doctor and have he or she examine you and help make a determination as to what structure was damaged.
The biggest concern on my part is that perhaps you did hit the bone. In these cases there is always the concern of a bone infection (osteomyelitis). Based on your narrative it does not sound like this occurred by again I cannot examine you.
So assuming there is no bone infection, here is what you can do.
If you notice the incidence of pain is becoming less frequent and the intensity of each incidence is getting weaker than I would just wait it out and over time it should subside all together. The problem is because it is the bottom of your toe and you are constantly walking on it, the ever day walking will prolong the symptoms, unlike, as an example, if you had stuck your finger with a pin; you could rest the finger and it would heal is a much quicker time frame.
On the other hand, if the intensity of the pain concerns you, then the logical choice would be to consult a local doctor.

Marc Mitnick DPM
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