A stubbed toe is a common foot injury in adults and children, often the result of walking barefoot and colliding with a piece of furniture or a curb.

Most stubbed toe injuries are not serious. After the pain subsides, we often go about our day as usual. However, there are times when a stubbed toe needs to be treated. Here are signs that you should see your doctor.

How to Tell If a Stubbed Toe Is Broken

• Pain that persists for a few hours or returns when putting pressure on the toe
• Discoloration that lasts for a few days
• Swelling that lasts for a few days
• Bleeding, an abnormal appearance of the toe, and an audible sound at the time of the injury are other signs that suggest a broken toe. People who have broken a toe are often able to walk, and they may not be in any pain following the initial injury, although walking and wearing shoes may be difficult because of swelling.

The symptoms listed above do not always mean a toe fracture has occurred, but they still warrant a visit to the doctor. An untreated fractured toe may result in complications. In some instances, these complications may end up causing more pain and costly or time-consuming treatment.

How Are Stubbed Toes Diagnosed?

In addition to toe fracture, a stubbed toe can result in a ligament sprain, contusion, dislocation, tendon injury, or other soft tissue injury.

These injuries are caused by the same mechanisms that produce toe fractures. Your doctor may order radiographs to determine whether you have a toe fracture or other injury.

Stubbed toe injuries in children, particularly of the big toe, can result in a more serious injury. According to one study, “stubbing injuries to the great toe can be a cause of occult open fractures and osteomyelitis” (J Pediatr Orthop, 2001).

Infections such as osteomyelitis can develop if treatment of an open fracture is delayed. Parents should keep a close watch on a child who stubs his or her toe and seek medical attention if any symptoms of a fracture develop.

What Are The Complications of a Stubbed Toe?

The two most likely complications of a stubbed toe are:

• Infection
• Osteoarthritis

An infection may occur when the skin near your injured toe is broken. Stubbing a toe with a benign ingrown toenail may cause an ingrown toenail infection, necessitating debridement and/or antibiotics.

A stubbed toe in an immunocompromised person—such as someone with diabetes who is more susceptible to infection after minor injury—can lead to a foot ulcer or infection of the bone.

Osteoarthritis is referred to as a “wear and tear” disease because the condition typically develops over time with the breakdown and eventual loss of cartilage in one or more joints.

Osteoarthritis may also develop after an injury, however, or even months or years after the injury. Osteoarthritis in the big toe, for example, is often caused by stubbing the toe or by dropping something on it.

Why Is A Stubbed Toe So Painful?

There are two reasons for the excruciating pain we experience upon stubbing our toes.

Our toes are densely populated by nerve endings that relay sensory feedback, such as pain sensations, to the central nervous system.

Our brains are programmed to give high priority to sensory input from the feet because they are in touch with the ground and play a critical role in preventing harm to the body.

Unlike other areas of our body, the toe has little fatty tissue or muscle to absorb the force of an impact. So when that large piece of furniture collides with a fast-moving child’s toe—with little tissue and lots of nerve endings—the result is going to be OUCH!

Before Seeking Help for Your Stubbed Toe

A “wait and see” approach to a stubbed toe is appropriate in most cases. Stubbed toe injuries often resolve without treatment. If symptoms persist after a few days, it is always best to contact your primary doctor.

Your doctor will ask for a detailed explanation of how the injury occurred and the symptoms you experienced at the time of injury and afterward. Be prepared to provide the following details:

• Description of how you were injured
• Initial symptoms at the time of injury and symptoms that you had before and after the injury
• Any other health issues you may have
• Your current medications and dietary supplements

Examination and Diagnostic Tests

If your doctor recommends that you come to the office for an evaluation, he or she will perform an examination of the entire foot. This may include:

• Inspection of the skin and nails for open wounds or significant injury, such as a bleeding under the nail (subungual hematoma).
• Inspection of all the toes for deformity; a visible deformity may indicate a displaced fracture or dislocation.
• Palpation of the toes and foot to reveal any point tenderness, which is typically present over the site of a fracture. Localized tenderness of a contusion may mimic the point tenderness of a fracture.
• Application of gentle maneuvers that move the toes upward and downward. This can help distinguish a contusion from a fracture.
• Assessment of capillary refill, the rate at which blood refills empty capillaries. Your doctor will take a toenail and apply pressure to blanch the nail bed. He will then release the toenail and watch to see how long it takes to go from a white, blanched appearance to a red, flushed appearance. This should take about two seconds. Delayed capillary refill may indicate circulatory compromise.
• Radiographs of the toes and foot if a fracture is suspected.
• Your doctor may be able to treat the injured toe in the office, or you may be referred to an orthopedist for further treatment.

How to Treat a Stubbed Toe

Although a stubbed toe often requires no treatment, applying ice to the toe may help reduce pain and swelling.

It is important to inspect your injured toe to make sure the skin is intact. Any break in the skin may invite infection; this is especially true in the case of an ingrown toenail. Cleaning the wound and applying an antibacterial cream is advisable.

Use common sense when wearing shoes after stubbing your toe. It may be best to avoid tight-fitting shoes until any pain or swelling subsides.

When taking care of a child with a stubbed toe, be sure to apply the same consideration about footwear.

Remember to check the toe over the next few days for any changes. If any new symptoms develop, it is wise to contact your doctor.