little toe swelling

by gloria
(Sioux Falls, sd)

I have a wide foot and have had bone spur surgery on my little toe and claw toe on the toe next to it 3 months ago/

My little toe has swelling near the toe nail and bruising on the side on the toe next to the outside of the foot.

My podiatrist gave me a cortisone shot 3 weeks ago which I am not sure has helped much. How long would a cortisone shot effects last.

My question is should I wrap the toe with coban even though the bruise is not gone or would that make the problem worse.

I need to wear shoes to work and walk constantly so it is hard to get over this.

I try to elevate my foot and am using advil and arnica.

I am having a terrible time finding wide enough shoes that do not press on my little toe so any advice you have I would appreciate.



thank you

RESPONSE

Hi Gloria,

At three months post bone spur surgery on your fourth and fifth toes, I would think you would be nearing the end of your "healing process". At this point there should be minimal discomfort when wearing conservative shoes like sneakers or laced shoes, but dressier shoes might still give you some issues.

The cortisone shot was not a bad idea but I will assume it hurt a great deal simply because of the location of your pain on the fifth toe. Having said that, either cortisone works or it does not. Sometimes it may take upwards of ten days to feel the full effect, but had the injection worked you probably would not of had to write this post.

Assuming there is no infection under the skin and your problem is inflammation or perhaps a problem with the incision, you could certainly try coban, but I have to tell you, on a small toe that you expect to get into a dress shoe, there will not be much room to wrap the toe and still get it into your shoe.

You might be able to wrap the toe in one layer, but beyond that, any more layers will tend to end up stuffing the toe into the shoe.

Has your doctor told you what the problem is as that would be very helpful in offering possibilities as to what to do next?

If you doctor is certain there is no infection, nor is there excessive scarring along the incision line, then you may have to look at the type of shoes that you are wearing to work.

It may be a case of trying to get a square peg into a round hole. Your foot structure may be such that it just not fit properly in a very stylish shoe (assuming that is what you wear). If that is the case you may to start looking for a different style, something that is boxier up front and perhaps even more important, a shoe made of material that "gives" meaning a material that will stretch somewhat.

This would include a very soft leather or suede perhaps. The converse would be wearing a patent leather shoe which has absolutely no give to it at all.

Even though you had the bone spur removed and so in theory you should be able to wear a dressier shoe, the simple fact that you are still trying to stuff your new toe into the same old shoes, may mean that you are continually aggravating the fifth toe and because of that, the toe may not be able to heal properly. Even with the bone spur removed, the incision is constantly rubbing into the shoe and that is creating inflammation and pain.

I do not have the luxury of actually examining you, but that typically is the scenario I see in my office. Even though we are entering the cold months of the year, you might want to consider wearing a sandal type shoe, for a period of time, to keep shoe pressure off the fifth toe and allow it to heal.

Your best option is to speak to your doctor as he or she is more familiar with your case than I could ever be.

Marc Mitnick DPM
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