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

Swelling on the ball of my big toe, left side.

by Jim
(Massapequa, NY)

I was running in my minimalist shoes (Vibrams) and stepped on a rock, right on the ball of my left big toe. I am male, 40, 190 lbs and it was painful. This was Memorial Day weekend 2011. It bruised and was swollen, but after a week that was all gone. What I have been left with is a small lump on the ball of my foot that won't go away. I've been a podiatrist and had x-rays that didn't show a sesamoid fracture (at least he couldn't see one). He recommended a Darco boot worn as much as possible, two Aleve twice a day, and 15min of icing twice a day. I did that for three weeks, although I did miss some treatments. I went back and he said he felt a little progress. I'm in the boot for another two weeks, and I've been treating it on schedule to the letter. I have another week with it before I go back again. I can walk on it, and it feels fine to bend the toe up or down through normal motions. The only time I feel any discomfort is when I really press down on it while barefoot on a hard surface like tile, concrete or wood flooring. What could I have done, and what are my true options? I am not considering cortisone or surgery, as there is little to no pain.

Please help, it's been 8 weeks already!

Hi Jim,
It "appears" as if your problem is getting better albeit more slowly than you would like. This is a problem that is typical of foot injuries. They can take longer to heal by virtue of the fact that every time you step down on the foot you are basically re-injurying an injured area.
Apparently, you damaged one of your sesamoid bones which is a small bone located behind the big toe joint.
In many instances a sesamoiditis can be a troublesome condition to overcome.
If you notice you are getting better as each week passes, then you are probably on the right course. It sounds to me that you are much improved as you state "there is little to no pain". If that is the case then just continue on your the course your podiatrist has prescribed.
If for some reason your progress comes to a halt, then I would recommend a bone scan to see if there is actually a fracture or not as sometimes xrays can be misleading.
You would want to know if the bone is fractured before having a cortisone injection.

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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Unknown location

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Poland

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location unknown

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location unknown

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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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location unknown

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Evansville, IA

Dear Marc

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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!

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Albany, NY

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location unknown

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Whichita, KS

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Boston, MA

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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

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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

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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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Melody

Lenoir, NC

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Rustam

Bellevue, WA

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Jodi

location unknown

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Swelling on the ball of my big toe, left side.

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