Needle embedded in toe joint

Podiatrist says that the needle has been in foot for soemtime. Located between second and third toe and seems to be going through toe joint. No swelling or infection seen. Podiatrist does not seem to think it is the source of my foot problems and says that people live with these foreign objects for years without problem. Seems to think removing will cause more problems and that no harm can come from needle being there and that it could over time dissolve or rust away. Told to come back if symptoms get worse. Suggested arch supported to keep pressure off joint. What do you think?

Hi,
"If" the needle is in the joint itself, it has to come out as it will damage the joint over time. Secondly if your present foot pain is in the same area as the needle I do not think it is far fetched to state that the needle is probably contributing to your pain.
He is right that when a needle is lodged in a certain way AND there is no pain involved, the needle can stay.
By the way, the needle is not going to dissolve and you certainly do not want it to rust as that would cause problems.
My best advice for you; get a second opinion.
Marc Mitnick DPM

I broke mmy toe and have an aircast... can i get crutches?

i went to the doctor and he didnt say anything about crutches. He gave me an aircast for my toe. it goes to my ankle. Can i get crutches if it STILL hurts to put any preasure on it?

Hi,
If the toe still hurts when bearing weight, than crutches might not be a bad option, but call your doctor first and see if he or she has any objections.
Marc Mitnick DPM

Pinky toe sprained

About 6weeks ago, my son fell during his Taekwondo class and sprained his pinky toe.
He had sharp pain in the begining but then the pain was getting better.
After one week, the pain was better and he was not complaining for any pain.
However the swelling was still same as the first day. I took him to doctor's office for a X-ray about two weeks ago and the bones were not fractured.
Why doesn't the swelling go away? It seems like a deformed toe due to the swelling.
When I press that toe, he says it hurts, but then at other time he walks and runs fine.

Hi,
Your best bet would be to tape the sprained toe to the adjacent toe in order to immobilize the sprained toe. This will allow it to heal faster and hurt less when he runs around.
Marc Mitnick DPM

5th metarsal stress fracture

by karen
(Mass)

Hello-

I noticed soreness on the outer underside of my foot, as if it was a bruised and tender when I would walk. I iced the foot both on the top and bottom. The next morning my outer foot near the pinky toe, on top and bottom was purple and 'Black and Blue.

ER sent me to an orthopedic who completed an XRAy and confirmed a 5th metarsal stress fracture. I have been in a boot, and feeling okay until the last three days I am experiencing tenderness.

Ortho ruled out metarsalagia because the tenderness is on top and bottom. I was told to wear the cast/ boot for another 6 weeks and the xray would be repeated.

An MRI has not been completed (Should an MRI be completed). How long does a stress fracture take?? I am pretty active and going stir crazy with this boot.

Thanks-
Karen M.

Hi Karen,
Followup xrays are the way to go. You would only consider an MRI when your symptoms did not match up to the xray findings. You are looking at 6-8 weeks under normal circumstances for the bone to heal, but as long as your doctor follows your progress with serial xrays, the correct treatment is being administered to you.
Marc Mitnick DPM

Pain whenever I bump the outside of my pinky toe

by Laurie
(New York)

For the last month or so, whenever I bump the outside of my left pinky toe, I get a sharp/stabbing, shocking, tingly sensation. I wouldn't say its horribly painful but very uncomfortable for a second and then fades. The type of sensation I get makes me think it's nerve related. It doesn't bother me otherwise...walking, certain shoes, etc. Only when I bump it on something or put pressure on it, like if I were to sit on my foot just right or squeeze the spot. It seems to be the area where the toe bone connects to the foot or just above there. There is nothing noticeable if you were to look at my foot...no redness, swelling, discoloration. I have no idea what it is. I haven't suffered a recent injury either.

Hi Laurie,
There are nerves that travel directly into the toe (that is why you have feeling in them), but particularly with the fifth toe, the nerve is subject to irritation primarily from shoes and the nerve can become inflamed. Thus whenever you bang it, you get that "jolt".
It is generally nothing serious, but more annoying. See a podiatrist; a shot of cortisone may go a long way in alleviating your symptoms.
Marc Mitnick DPM

big toe pain persisting months after jamming it

by michael
(las vegas)

i jammed my big toe very badly about 3-4 months ago, it was swollen & bruised a few inches passed my toe even (just to explain how hard i hit it) i'm sure it broke it, it was swollen for about 2 weeks afterwards and still stayed bruised about another 2 months until it disappeared completely, but the toe still hurts. it doesn't hurt nearly as bad as it did, it's just enough of a pain to be slightly annoying. what i'm wondering is if this is normal for jamming/breaking a toe? is it just because of how badly i jammed it? when should i expect it to be completely healed?

Hi Michael,
This is the problem with fractures of bruises that go unproperly treated they may result if chronic pain.
I would suggest you see a podiatrist, have an xray and get a good assessment of what is actually going on.
Marc Mitnick DPM

Sprained ankle

by Doug
(Boston)

I sprained my ankle 4 months ago. It was a bad roll. I was running and I stepped on a uneven cobble stone and I rolled right ankle. Black and blue and very swollen. Iced it and kept off it for a while w/ the small boot the doctor gave me. He said it was not the worst sprain you could have out of the 3 grades but probably the 2nd worst. Its now been 4 months since then and the ankle is still swollen on the exterior bone the the ankle and clicks when I rotate it. Does not hurt allot anymore but still feels stiff in the morning and hurts when I run on it. Seems to hurt on the exterier instep closest to the base of my leg and sometimes hurts at the base of my heal. I had Xrays taken and no bones were broken.

Question. How come my ankle now makes a clicking noise when I rotate it and when will the swelling go down on the exterior bone area of my out side foot?

Thanks
Doug

Hi Doug,
You might have had some real soft tissue damage, like torn ligaments which of course would not show up on xray.
Since the area is still swollen, physical therapy might prove very beneficial. If it does not help then I would think an MRI would be in order.
Marc Mitnick DPM

i sprained my ankle 2 weeks ago

by judy
(belon,mo.)

i've been off my ankle for 2 weeks my doctor said to get off my cructhes and put a ankle brace on my ankle so yesterday i walked on my foot with the brace and the bottom og my foot is very painful and my ankle is swelling back up again i took prednisone for 12 days so should i just suffer with the pain and keep putting weight on it i had xrays and nothing was broke what to do? thanks judy

Hi judy,
If it hurts to bear weight on the foot then go back to the crutches, give it another week, if it is still too painful to walk then you might need another xray as sometimes fractures do not show up initially.
If that is not the case, then ask your doctor about some physical therapy to speed the healing process.
Marc Mitnick DPM

Fractured Baby Toe

by Emma
(California)

I stubbed my right baby toe on the corner of a wall on 9/11/09. Of course, it hurt exremely bad. I assumed I had just sprained it, so I didn't go to the doctor right away. 8 days later, I still had extreme pain, bruising and swelling. I finally went to the doctor who took xrays and confirmed it was broken. He gave me a blue surgical shoe to walk on. He asked that I buddy tape it for a couple of weeks and that it should take upto 6 weeks to fully heal. At 6 weeks, I still had pain, swelling and bruising. So I returned to the doctor for a follow-up. They took another xray and found it had not mended and looked worse than before. Because the fracture was at an angle, the top of the bone slipped down causing a "thickness" in the middle of my toe". This explained why my toe was so pudgy. This time he put me in a black ski looking boot and referred me to a specialist. Two days later I saw the specialist who recommended we cast my foot for 3 weeks. If after 3 weeks it still hadn't healed, they would do surgery. Well in 3 weeks I was back at the specialist office and they removed my cast and took 3rd set of xrays. It hadn't healed and was worse than before!! Now I'm scheduled to have surgery to repair it. Doctor stated he would do a minor 15 minute surgery to remove the fragment and I would not need pins. He said I would be as good as new in 2 weeks.

My question is: What is the exact surgical procedure? Where will he cut? Is using pins a better option?

Hi Emma,
Sounds like you have a chip fracture where part of the bone has "chipped" away from the main bone. He is just going to go in and remove the chip. You do not need pins, it is a 15 minute procedure , but I have no idea where he is going to make the incision as that is up to him, although just guessing, I would say right along the top of the toe.
Marc Mitnick DPM

Sore foot after/during football

by Nick
(Scotland)

When i first kicked the ball. The top of my foot and instep became very sore.
Now walking hurts at various points during the day, the pain comes and goes but is clearly still there a week after i played.
When i was playing the pain left however it may have been due to numbness or adrenaline through playing.
The pain arived again almost immediately after i stopped.

Hi Nick,
The sensible suggestion would be go have an xray to make sure there is no fracture. Assuming no fracture the next thing I would look to would be a tendonitis of one of the tendons on top of your foot. You will need the attention of a foot specialist in order to give you a proper diagnosis.
Marc Mitnick DPM
Do you have any solutions as to what this can be

fracture to 2nd metatarsal base not healing

by Carolyn
(Brooklyn, NY)

According to my MRI, I have a small, incomplete non-displaced fracture to the base of my 2nd metatarsal (3mm low signal focus) along with a subacute osteochondral injury. There was also a small subacute ostechondral injury to the head of the lateral cuneiform and mild generalized narrowing of the 2nd tarsometatarsal space. My ligaments all appear to be intact and there was no subluxation/dislocation found. So far I am being told that I don't have a lisfranc injury. I have osteopenia and hurt myself sleeping when my foot was held back a little far by sheets for several hours. My foot bones were "weakened" even more because I was 4 weeks non-weightbearing healing a stress fracture in my hip. I guess the bone gave out. Apparently, the fracture isn't a stress fracture but it isn't visible on x-rays either. My podiatrist said the osteochondral injuries could be incidental findings so I don't have a true understanding of what they are. Anyways,there is not much info out on the location of my metatarsal fracture that isn't related to a lisfranc injury. I was non-weightbearing with a cam walker boot for 3 weeks. My podiatrist told me I could walk again in sneakers at my followup because I didn't have any pain when he pushed on the bone or manipulated my foot. I also don't have any swelling or bruising. He x-rayed my foot as well but the fracture still didn't appear. I still have a sharp pain over the 2nd metatarsal shaft whenever I put pressure on the forefoot. My first concern is that the pain is there because the fracture isn't healed yet and my second would be that maybe I do have a undiagnosed lisfranc injury. I have had weightbearing x-rays and, according to my podiatrist, they don't show any displacement of the joints. I don't have a true mechanism for a lisfranc but the location of my injuries has me suspicious. Is it possible to have a fracture to the base of my 2nd metatarsal and not have a lisfranc injury? Since the fracture is at the 2nd metatarsal base, should I be walking at all if I don't have a real confirmation that it is healed?

Hi Carolyn,
I am not really clear on the time line here, but if you have only been in a cam walker for three weeks that may not be enough time if a fracture is suspected. Immobilizing the foot (with a cam walker) is an excellent way to allow the whole area to heal whether it be a fracture or ligament damage.
If you suffer from osteopenia and if you smoke those factors will delay the healing process. Discuss with your podiatrist the possibility of staying in the cam walker for a longer period of time.
I know nothing about your medical history or your size but I have to tell you from a conceptual standpoint I do not see how you could have sustained so much damage from sleeping in the wrong position; indeed at the very least I would have suspected possibly some soft tissue damage but not a fracture.
Your podiatrist might want to consider a bone scan to confirm the fracture.
But, as I said before perhaps a longer time frame of wearing the cam walker and even perhaps some physical therapy might move this problem along at a faster rate.
Marc Mitnick DPM

Should I go see a Dr. after i fell off a curb?

by Cayce
(NM)

I was diagnosed with Neuroma on my left foot in late May. I did physical therapy and it only flares up once in awhile. Today I fell off the curb at twisted my ankle. It's very painful and it kills me to walk on it.

Yes, Cayce, go see a doctor and have an xray.
Marc Mitnick DPM

broken metatarsals

by Suzanne Avitabile
(Yonkers, NY, USA)

I broke 4 metatrsals (2-5) and dislocated the big toe of my right foot. The 4th metatrsal was basically "pulverized" according to my surgeon. I've had 26 screws and five plates put in my foot. The incident happened on July 19, 2009. It has been 2 months now and I am walking with an air-cast boot. The first 7 weeks were completely non-weight bearing. My question is how long will it be before I can safely drive and is there any kind of footwear that would expedite this? I am willing to wear the air cast before getting into the car and after getting out, but the thing is so bulky and non-flexible, that driving with it would be very hazardous. I am back at work (after 5 weeks), but don't want to keep imposing on my co-workers, etc., to get me to and from work. Also, of course, is my desire to be independent again. I am 52 years old and this is the first time I have broken anything. I'm not even sure how it happened. The closest I can estimate is that I passed out (I have orthostatic hypotension), had a seizure and flailed the top of my foot into the bottom corner of my refrigerator. At least that's the way it seemed when I came to and saw my foot. The fifth metatarsal was a compound fracture with a bit of bone breaking through the skin. Is there some sort of shoe or removable cast that would afford me the protection and flexibility to drive?

Hi Susan,
I would have thought your surgeon would have given you these answers and that is probably who you should ask, but in general a rigid sole laced oxford, large enough to make room for the swelling you are probably still experiencing would be the best shoe for you. But, please ask your surgeon since he or she is still ultimately responsible for your care.
Marc Mitnick DPM

Multiple avulsion fractures

by Lisa
(MI)

I fell off a porch a month ago and have three tarsal avulsion fractures and several on both sides of my foot. I was in a splint for 4 weeks, the doctor was going to put me in a cast for another couple of weeks, but put me in a walking boot instead. HE did this because I am having tingling in my foot (I am not diabetic that I know of) and he thinks I am having more pain than I should based on the X-ray and MRI results. I also mentioned that at times I think my foot is straight, but it is actually turned to the side. He said it sounds like "RSV", the nerves stuck on high, but I can't find anything about RSV other than a respiratory virus. What is RSV and is my doctor telling me I am too sensitive to pain? I have always thought I had a high pain threshold.

Hi Lisa,

It is RSD and you can find it HERE. This can become a very serious condition and if your doctor suspects you have Reflex Sympathetic Dystrophy, you should be seen immediately by a neurologist or anesthesiologist who specializes in pain management.
No treatment, or under treatment can potentially lead to permanent disability and a lot of pain.
Speake to your doctor about your next course of action.
Marc Mitnick DPM

Lisfranc injury to left foot

by Amy winkler
(Phoenix as)

Injured foot on June 26 2009, went immediately to emergency room because foot was at odd angle especially at the arch.
They xrayed and Cat scanned my foot. Told me I had dislocated and fractured foot. They twighlight sedated me and set foot into a splint.
Their orthopedic surgeon referred me to another foot and ankle specialist. I went to see him and he perfomed surgery to fuse bones together using screws. Surgery took place 2 weeks after injury. Should be noted I have hypermobiliy in all my joints. He gave me a popiteal block before surgery. When I went back two weeks later,, he removed the big bulky cast with the polar care cooler hook ups and put me into fiberglass cast. The popliteal block still not worn off by then. I asked him how surgery went and he told me that. It was not as bad he thought and foot looked good. I asked if I should be concerned that block not worn off yet, he did not seem to be overly concerned. He took me off hydrocodone and kept me on oxycontin and tylenoll. It has been three and a half weeks and block still not worn off ccompletely. Side of knee and down calf can feel touch but still feels kind of numb and tingly to the touch. Cannot move toes at all unless use whole calf muscle. Which I can feel working in cast. Foot still very swollen and experiencing bad pins and needles, electrical shocks, and tingling at night that keeps awake after three and half weeks post op. Is there something really wrong?

Hi Amy,
From an outside observer it sounds like you have nerve damage either from the popliteal block or from the cast. In either event if your symptoms have not improved, you need to see a neurologist immediately because the longer you wait , the greater the potential for permanent damage.
There is also the possibility of CRPS (read my section on this) and again the best person to treat this would be a neurologist.
Do not delay getting a proper diagnosis.
Marc Mitnick DPM

heavy object fell on foot

by Jay
(Canada)

I was working in my home when a piece of drywall fell on my left foot it become swollen so fast it looks like I have an egg inside my foot. It's not broken and I can walk on it. I'm putting ice on it. I was wondering do I need to see a doctor or will the swelling eventually go down.

Hi Jay,
How do you know it is not broken? Unless you have had an xray, you really cannot tell.
If after a few days (since the trauma) if the foot is not feeling appreciably better, I would consult with your doctor.
Marc Mitnick DPM

I have a break in the cubiod, in a fiberglass cast.

The sweeling in the bottem of my foot is making my foot numb.Motrin is not touching it. I have Allopurinol for gout. Can I take it to help with this? Will it fight against my bone healing? The foot is throbing and burning as I type. It is up and I am only getting up to use the bathroom. It has been almost 3 weeks in the cast.

Hi,
If you are having these kind of problems you need to call your doctor. It is his responsibility to help you and give you guidance as to what to do and what medications to take.
Marc Mitnick DPM

electric shock frequently on ankle I broke last summe

by dana
(Tx)

I had a green stick break on my right ankle last summer but recently I have had these breath taking elecric shocks that pulsate below my ankle. If I take 2 Motrin every 4hrs it lessens the frequency but does not get rid of it completely. Its getting where it affects my driving and teaching. What else can I do?

Hi Dana,
There may be a nerve entrapment in the area of the fracture that are giving you those electric shocks. I would suggest you see a podiatrist or orthopedist as there are things that be done for your symptoms .
Marc Mitnick DPM

broken metetarsal and ankle sprain

by melanie
(cornwall)

i broke my metetarsal 3 weeks ago and sprained my ankle badly. have had 3 weeks in a hard cast. had the cast taken off 4 days ago. my foot has swelled up like a ballon which goes up to my ankle and calf and im in a lot of pain. i am resting my foot as much as possible but very worried about the pain and the swelling.

Hi Melanie,

I have never seen a broken bone heal in three weeks. You may need to be back in the cast. Mention this problem to your doctor.
Marc Mitnick DPM

Year old broken toe feels funny

by Julie
(OP, FL)

Last year I broke the toe next to my big toe. Saw the doctor, he said to keep it bandaged to the big toe, but I work on my feet and it was uncomfortable. Now, because I didn't do that, my toe curves to the left. And now it feels like I have a thread on it. Every movement I make with my left foot feels like the toe is brushing over stuff. What could this be. Sometimes it is uncomfortable to walk on that foot.

Hi Julie,
There is a possibility that you have a non-union. This means that the fracture site did not properly heal. The fact that the toe is deviated certainly suggests that.
You will need another x-ray to see the status of the broken bone. Depending on the situation a bone stimulator or surgery may be your only options.
Marc Mitnick DPM

Possible tear of the ligament on the second toe

I have very flexible/double jointed toes ? can literally point the toes upward. I also have a hammertoe on the second toe. A couple of weeks ago ? I was kneeling on the ground and pushed up on the foot of my foot/bent toes and felt a very strong pain. Since then ? there is pain under my second toe and the ball of my foot. It is better when I cross wrap my toe with elastolast and pull the toe straight. I went to see a podiatrist and quite honestly came away not impressed. He did not effectively communicate course of action and what to do next. I am taking Naproxen now and he mentioned if the pain does not go away then we would proceed with cortisone shots. He told me to take it easy for 6 weeks. My toe does move a lot/out of place - so he thought the ligament was torn or stretched?? My concern is that without imaging the toe how does he know what to do next??.
I am a an avid cyclist and hiker and my foot hurst after every ride or hike.
What do you think??

Hi,
An xray would be indicated to rule out bone pathology but based on your story, it sounds like more of a soft tissue problem. Read my section on capsulitis; that is what it sounds to me.
Capsulitis is a readily treatable condition through the use of metatarsal pads within an orthotic. Rather then telling you to rest for six weeks, I would recommend asking him about a foot insert of some sort along with perhaps a cortisone injection, if you are finding the Naprosyn is not helping.
Anyway, I am not sure how an active individual can actually "rest" a foot. Things like walking up and down stairs, kneeling to pick up something all aggravate capsulitis. See about having some further treatment now, before it gets worse.
Marc Mitnick DPM