Sprain of a toe

definition

Under a sprain called a Distortion (lat. distorsio - twisting) means an overstretching of a joint together with its joint capsule. Most of the time, sprains result from minor accidents in which the force applied is too little to cause more serious damage. In addition to almost all other joints, one or more toes can be affected by such an injury. The little toe, which is often injured due to its marginal position, is particularly common. Of course, all other toes can also be affected.

causes

In contrast to other sprains (foot, wrist, ...), the cause of a sprain of a toe is usually not a sports accident, but an everyday injury. Patients often report that they have bumped into a corner or edge while walking barefoot or that they did not notice obstacles in the dark in time. These situations are very painful, but mostly not serious enough to break toes or other parts of the body or, for example, to permanently damage a muscle. Of course, there are many other possible causes of accidents and serious accidents can "only" result in a sprain. The causes of this injury can be as varied as the patients who suffer it.

Symptoms

The classic symptoms of a toe sprain are severe pain at the affected joint - usually it is the joint that is at the transition from foot to toe - and swelling in the same place. Those affected often complain of pain when walking and an altered function of the toe. In addition, a bruise on or below the toe can occur either immediately or after a few hours to days. On the other hand, the toe should not stick out from the foot at unnatural angles and open wounds would be very unusual.

Figure sprain

PECH scheme

Sprain (distortion) -
Ligament or joint capsule
injury
Tape -
Ligament
Joint capsule -
Articular capsule

1 - 1 - Upper (proximal)
Wrist -
Articulatio radiocarpalis
2 - 2 - lower (distal)
wrist
Articulatio mediocarpalis
3 - 3 - knee joint
Articulatio genus
4 - 4 - Upper ankle -
Articulatio talocruralis
5 - 5 - Lower ankle -
Articulatio talocalcaneonavicularis

PECH rule
Break Ice Compression Elevation

You can find an overview of all Dr-Gumpert images at: medical illustrations

Treatment - what to do

So what should you do if you have a sprained toe? At first, the PECH rule also applies here - although, as mentioned, it is usually not a sports injury.
Consistent cooling and elevation of the foot relieve pain on the one hand and can also effectively reduce the development of large bruises and swellings on the other. This is followed by compression using elastic bandages or tape bandages. It is important that the bandage is tight enough to provide support, but not so tight that it constricts the blood vessels or nerves of the toe. If you have cold, pale toes or an uncomfortable tingling sensation under or behind the bandage, you should loosen it immediately and put it on again.

During the days following the accident, you should always put your foot up and take the pressure off. If the pain is very severe, taking a so-called non-steroidal anti-inflammatory drug (NSAIDs) how for example Ibuprofen or Diclofenac respectively. However, this should only be done for a short time and / or in consultation with a doctor, since these drugs can of course also cause side effects.

Read more about this under NSAIDs - nonsteroidal anti-inflammatory drugs

Applying an ointment

In the case of moderate pain, the treatment measures mentioned above can be supplemented with an analgesic ointment (for example with Diclofenac) on. This is available over-the-counter in the pharmacy and can be applied directly to the injured area. The anesthetic agent relieves the pain and - depending on the preparation - may even cool you down.

In addition to using a pain ointment, some doctors recommend therapy with ointments that promote blood circulation. Applied after the first 48 hours (important - never before), they are intended to promote blood flow and thus the removal of any bruises and swelling and to wash away nutrients and energy for the regeneration of the injured structures. Whether and how exactly this effect can occur, however, is not undisputed; some doctors do not certify that these ointments have any other effect other than the placebo effect, which makes the patients believe in a quick healing.

Read more about this under

  • Diclofenac
  • Ibuprofen
  • Voltaren®

Taping

In addition to bandages made of elastic bandages, taping a sprain of the toe can also be a good way to stabilize and immobilize. The best way to do this is to use a relatively narrow, not too thick sports tape, which is wrapped in a ring around the injured toe. One or two wider stripes (so-called Reins) are glued towards the metatarsus to provide additional stabilization.

Similar to the elastic bandage, the feeling in the affected toe should be checked before and after the tape is applied. Is the toe still warm and rosy despite the tape? Or is the patient already complaining of abnormal sensations, tingling and numbness? The latter are clear signs that the tape is too tight and should be loosened and reapplied as soon as possible.

Read more about this under

  • Tape bandage
  • Kinesio tape

How long does it take?

The duration of a toe sprain is, to the delight of many sufferers, in most cases a fairly short matter. How long exactly the healing process takes is a very individual matter. The duration depends on the severity of the injury and the overall condition of the person concerned. Those who consistently raise and take care of themselves will also experience an improvement faster than those who continue to walk a lot. The most unpleasant thing is often the event itself that leads to the sprain and the day immediately following. Especially when using a stabilizing bandage and wearing sturdy shoes, a significant improvement can often be noticed on the second day. In most cases, patients experience almost no symptoms of their toe sprains within a week. Just as quickly as the pain disappears, moderate stress, for example during exercise, can then be resumed.

Please also read our article on this Duration of a sprain.

Difference between small toe sprain and big toe

Important differences in toe sprains result from which toe is affected in each individual case. The big toe is very important for walking and balance, and it is also the only one of the toes that would possibly be operated on if there was a fracture. In the case of an injury to the little toe - regardless of whether it is a sprain or a broken bone - there is usually no possibility of an operation, so that the same therapy of taping or bandaging and lying up will be performed in both cases. Therefore, if only the little toe is affected, in most cases it is not absolutely necessary to see a doctor. Nevertheless, in case of doubt, a visit to the doctor is of course always possible to be on the safe side.
However, if the big toe is affected by the symptoms of a sprain, you should always go to an orthopedic surgeon or trauma surgeon quickly to have the injured foot X-rayed. Under certain circumstances, this may have completely different consequences for the further procedure. In summary, one can say that sprains of the little toes are welcome to be shown to a doctor, and sprains of the big toes should be shown to a doctor!