severe burning and pain on toe

by Deborah
(Flushing MI)

It all began with severe pain and a burning sensation when I walked and stood. My toe felt like it was frozen, yet, it burned and exuded pain. I would sit down and look at my toe and it would be ice cold. It would take about 30 minutes to warm it up...the pain was excruciating as I was trying to warm it just with my warm hands wrapped around it. I would take a bath and the warm water would burn so bad that I had to take my foot out of the water. When I do this, my toe is a dark purple. Now, my toe looks red, raw where skin has peeled away and is extremely sore. I have it wrapped so that it does not touch the sides of my other toes (in gauze bandage). This has been going on for quite some time and it does not seem to get better. I am wondering what could possibly be wrong with my toe...should I go to the doctor or wait a bit longer?

RESPONSE

Hi Deborah,

In order to give you a more complete prognosis I would need to know more about you, primarily your age, any circulatory issues including heart disease and whether or not you smoke.

I will start off by saying I think you should probably have a doctor look at your toe simply because in a worst case scenario this could be a major circulatory embarrassment to your second toe.

It has been an exceptionally cold winter and I am positive Michigan is no exception. In a best case scenario, when you are outside, the cold weather is causing a vasospasm (closing down of the arteries that bring blood into the toes). This would be exacerbated if you are a smoker. The toe can very well become painful as well as very white in color. As the toe warms up in the warm room, and blood starts to flow back into the toe, that too can cause pain.

The WORST thing that you can do is to soak your foot in hot water. Hot water puts metabolic demands on tissue and if you are not getting enough blood to the tissue (second toe) in the first place, you will start to see breakdown of tissue leading to ulceration, possible infection and in severe cases gangrene.

So, until you get to a doctor who determine whether or not there is an underlying problem or this is nothing more than a simple response to cold weather, there are a couple of things you can do.

Wear insulated socks to keep your foot as warm as possible. If you have to wear stocking and pumps to go to work, for example, cover your feet with insulated socks and boots and change when you get to work.

Avoid standing outside for prolonged periods. The colder and damper it is outside, the less time you should be outdoors.

If you are a smoker--STOP.

When you do have one of these attacks, put your foot in very slight warm water, after a few minutes keep adding warmer and warmer water until your toe returns to normal color. Again, trying to warm up your toe too quickly may cause tissue to die.

The type of doctor you should see is a vascular specialist. If this is ends up being nothing more then a vasospastic reaction to cold weather, then once the temperatures begin to rise, you should have few and less severe incidents. But, remember, the same thing will probably occur again next year.

Marc Mitnick DPM
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