Needle like object stabbed under my toe horizontally

by Grace
(Cedar hill, Tx, USA)

Last night I was walking and when I walk I tend to drag my feet. So as I was walking a needle like metal stabbed through my foot, I got it out. The little padding under my toes started swelling especially under my big toe where the needle stabbed through. The swelling is a painful throbbing and it won't go down, Ive been appliying ice and having my foot above the level of my heart. The swelling is starting to affect the movement of my toes and I can't walk on my right foot without feeling pain.

RESPONSE

Hi Grace,

There a few things to consider here. You may be having a reaction to the object that pierced your foot. There is also the possibility that you actually punctured a vessel in the area or traumatized some soft tissue structure most likely a tendon. There is also the possibility that there is still something in your foot.

I say this because usually when someone steps on a foreign body, then pulls out the entire object, there is rarely the type of reaction that you are having. Most people will have a little tenderness, but rarely will their foot "blow" up like yours has, especially in such a short period of time.

I have seen over the years many patients who "think" they have removed the entire needle only for me to find a remaining piece because the needle ends up breaking and leaves a portion in the foot. If you happen to still have the needle, check it to see if it is completely intact or if there appears as if a piece is missing. If so, then you may assume the missing piece is still in your foot.

If there is still some piece of needle in your foot there is always the possibility that you may be having what is known as a foreign body reaction to the needle and that will cause localized pain and swelling in the part of the foot where the needle went in.

Since it usually takes 36-72 hours for an infection to begin and it has been far less then that since you stepped on the needle, I do not think the swelling is indicative of an infection (just yet).

As mentioned there is also the possibility that you punctured a blood vessel, usually a vein, that may have caused the foot to swell in that area.

By the time you receive this response it will be a few hours later. If your symptoms have not begun to resolve then you should seek medical care to determine primarily if there is still a portion of the needle in your foot.

If you are sure it was actually a needle then the good news is something as simple as an x-ray should reveal if there is still a portion of the needle in the foot, since needles are metallic and metal objects will show up on x-ray.

Perhaps the worse thing you can do at this point is to try and bear weight on the forefoot in an effort to walk. If that portion of the foot is very painful, obviously, it will be difficult to bear weight, but by putting pressure on that portion of the foot, you run the risk of pushing the needle further into your foot, if there is still a piece of the needle in your foot, and that will make it more difficult to move.

So, my suggestion would be as follows: if you have access to crutches you may want to use them in an effort to keep pressure off the forefoot. If you do not have access to crutches, you should try to walk just on your heel so that you do not do any further damage to the forefoot. With that in mind, get yourself to the nearest medical facility and have a doctor look at your foot. I say all this because your foot is not reacting the way most people's feet react when they have stepped on a needle AND been able to remove the whole needle.

Marc Mitnick DPM
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