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swollen 2nd toe

by Dot
(Ct)

Back in May, I stepped on a small pebble which had gotten into my shoe. I removed it quickly, but it was still sore. I didn't think much of this until the next day when I could barely walk. I made an appointment with a podiatrist, and he diagnosed me with bursitis. He gave me a cortisone shot in the toe and told me to come back the following week for a follow-up visit. The next week, he took x-rays and told me I needed the bunion removed Then told me that I would need orthotics. He then gave me a 2nd cortisone shot. Well, I could barely walk when I left is office. A couple days later, I noticed the toe was swollen and very sore. It also started lifting up. I called and made another appointment with the podiatrist, asking him if the orthotic would help the swollen toe or hinder it. He then told me that all he could do was bunion surgery and the toe would drop back down where it belonged.


He said nothing as to why my toe was still swollen, but just that I needed bunion surgery. I decided to wait a few weeks and see if it got better. Well, it didn't and began to hurt badly again. Now, this podiatrist never said anything about wider shoes or any other kind of non-surgical remedy. I decided I needed a 2nd opinion.

I made an appointment with an orthopedic surgeon, hoping that he could do something about the swollen toe. Well, he looked at it and told me that toe was in the early stages of hammer toe and that it would get worse. Since it was still flexible, we could try taping it or wearing a toe straightner to see if that would help. He told me that the toe would not just drop back into place after bunion surgery due to the 2nd cortisone shot. Well, he taped it and later that night, I was in excruciating pain, so I removed the tape. Now, I had been wearing a toe tube over the toe to keep it from hitting the shoe. I also bought wider shoes with a deeper toe box.

He, too recommended bunion surgery, which I told him that I would consider after the holidays, since I would have to be out of work for 2-3 months. He told me he would also have to do hammertoe surgery, and he could see the base of the toe was still swollen.

Now, no one can tell me why my toe is still swollen 6 months later, or even how to get the swelling to go down. Funny thing is, the bunion doesn't bother me, just the 2nd toe. Neither icing it, nor taking anti-inflamatories are helping.

Any help would be appreciated.

Hi Dot,
May I assume the big toe is going under the second toe? If it is then you may need bunion surgery; if it is not then both these doctors are selling you a bill of goods.
My guess is you have capsulitis (read my section on this subject), when you stepped on the stone, it hit right in the same area and inflamed the area, that is why it is still painful and swollen.
Ask your doctor to place a metatarsal pad on your foot to change the dynamics of how you walk. I would also take some anti-inflammatory medication (if you can tolerate it). If this combination helps then you might want to consider having orthotics made with a metatarsal pad built into it.
As a side note you may want to have a doctor check the area just to make sure you do not have an infection as a result of the injections.
Marc Mitnick DPM

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Sep 01, 2009
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Dot, you've been reading my mail!
by: Colleen W.

Wow! The same thing happened to me, Dot. It was yoga though, not a rock. Pain, cortisone, toe sticking up in the air...yuck! Anyway, my podiatrist said the same thing, except he also mentioned 'trimming' my second toe because it is longer than my big toe. I realized later that the trimming was a partial amputation! Sheesh. Anyway, I am trying my best to keep the little bugger flexible, but the tendency for the toe to pull up means that normal taping doesn't do it. I have tried a broken popsicle stick and tape, but wrong placement means that the end of the toe can fall asleep. Anyway, I am going to raise a little hell with my GP who had nothing to do with this, but I need a referral to a specialist ASAP or I will be seriously angry. I am having trouble hiking and walking and bending without a pain shooting up the top of my foot.

Thank you for taking time to share your story and giving me a feeling of belonging. Hard to get your friends to take this thing seriously, but it really cramps my style and I need it fixed!

Colleen

Jun 16, 2009
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sounds like my toe except I have not bunyon
by: Anonymous

I have been dealing with a swollen second toe for almost a year now. I think it started last summer when I wore flip flops. My doctor said it was bursitis and I bought arch supports and pads to change the pressure point on my toe, but no relief so then I saw a podiatrist, he shot it full of cortizone, and after a month and no relief he changed to Keflon (?) It was improving, but not better. About 3 weeks ago I had a red streak from the toe running up to my ankle, my doctor put me on an antibiotic and the streak is gone but the swelling and now a red area behind the toe has developed. Very squishy and painful like a bruise. Nobody seems to know what it is or why the streak or why the swelling.

Oct 30, 2008
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Bit of follow-up
by: Dot

OK...although the big toe is not resting under the 2nd toe, it does hit up against it, forcing me to put a small sports bandage on it to keep the nail from digging into the 2nd toe. Therefore, I do think I may need the bunion surgery, even though the bunion doesn't hurt. I do have a problem though, with getting shoes that I can wear, but I think that is mainly due to the 2nd toe. I have tried OTC metatarsal pad inserts (gotten from my shoe store person that handles orthotics). I also purchased a metatarsal cushion, which does seem to help my foot when I use it in conjunction with taping the metatarsal area with sports tape so I can walk on it during work. My main problem with the 2nd toe is that it does NOT want anything touching it where it joins the foot (area of the cortisone injection). Unfortunately right now, those bother me too much to use constantly right now. Makes it feel like a big rock in my shoe. I will check out a possible infection and the capsilitis. Thanks for your help. I will make an appt with my primary care doctor and have him see what might be going on.

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