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The response to the question below was authored by Marc Mitnick DPM

redness, swelling and pain below third toe

by Susan
(Cleveland)

Hello Doctor. Thank you for providing this helpful site. I've been searching for answers. I'm a 49 yr.old female. Five days ago (Monday) I noticed pain in the top of my left foot beneath the third toe while I was out shopping. I had not done anything stressful that day. Two days prior (Fri and Sat), I had worked in sock feet on a concrete floor for two days in a row. I don't remember any pain at the time. The day following those two days (Sun), I was resting off my feet for most of the day. (I'm currently undergoing radiation treatments for breast cancer on the left side). I showed my foot to the Oncologist on Tuesday (it's swollen on the top near the toes and has a red area, about 2"x3" near the toes). It's painful to walk and aches sometimes when I'm sitting. They wanted to rule out a blood clot, so I had an ultrasound and it was negative. They told me to take it to my family doctor. I have an appt. for Monday. About 14 months ago I stubbed my third toe, could this just be an aggravation of this old injury? It hurts to bend my toes forward or backward together, but you can wiggle each toe back and forth with no pain. No swelling in toes. Last night I took a couple of Advil and used an ice pack and that allowed me to sleep.

Thank you,
Susan

RESPONSE

Hi Susan,

While I was reading your narrative the first thing that came to mind was a stress fracture. These can occur without any real history of trauma. In most cases

it can happen from just everyday activity and that is why people are surprised to find out they broke their foot when there was no history of trauma to the foot.
The next most probable diagnosis would be tendonitis or inflammation of the tendons on top of the foot. These are the tendons that allow you to bend your toes upward.
Again, there does not have to be a history of trauma. It is usually a result from overuse.
Another possibility, based on where your pain is located is an inflammation of the joint that attaches the second toe to the metatarsal bone. An example would be something simple as an arthritic flare up.
So, how do you know which condition it is? The first thing I would suggest is not to bother with your family doctor; this is not their area of expertise. Instead, I would suggest you consult with a foot specialist who is better equipped to narrow down the options.
The first thing you need is an x-ray to rule out a stress fracture, keeping in mind that sometimes very small fractures do not always show up on an initial x-ray, so the x-ray may have to be repeated a week later or your doctor might consider a bone scan.
An x-ray may also show the condition of the second metatarsal phalangeal joint to see if there are any signs of arthritis within the joint.
If, the x-ray is negative for both the above mentions problems, then you are probably suffering from tendonitis.
Whatever the diagnosis, a foot specialist will be able to give you guidance on the best way to treat it.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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Orthotics for multiple types of foot pain best buy in a pre-made orthotic click link below

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(location unknown)

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(location unknown)

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(location unknown)

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(location unknown)

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Unknown location

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New Zealand

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Arizona

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Poland

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South Carolina

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location unknown

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location unknown

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Bre

location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Poland

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Seattle, WA

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location unknown

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New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown

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location unknown

Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

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Evansville, IA

Dear Marc

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Russ W.

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location unknown

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Jackie

San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY

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Jill S.

location unknown

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Jackie

Whichita, KS

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mark

Boston, MA

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....Keep up what your doing. Your a life saver.

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Colorado

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown

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Canada

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location unknown

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Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown

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Renae

North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Lenoir, NC

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Rustam

Bellevue, WA

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Jodi

location unknown

redness, swelling and pain below third toe

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