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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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(location unknown)

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(location unknown)

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Mansfield Ctr, CT

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Placentia, California

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Unknown

Unknown location

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Unknown location

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Pacific Grove, CA

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Alameda, California

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New Zealand

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Sincerely

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Arizona

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Florida

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Poland

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South Carolina

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unknown location

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Arlington, VA

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San Clemente, CA

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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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Chrissy

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!

Tracy

Evansville, IA

Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

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-Sunny.

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

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown

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Jackie

Whichita, KS

thanks again, this site is very helpful.

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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annielou

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

Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

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Canada

I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

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location unknown

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Nancie

Wisconsin

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

Julie

location unknown

Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

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

I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!

Melody

Lenoir, NC

Thank you so much Doc for a quick and thorough response!

Rustam

Bellevue, WA

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Jodi

location unknown

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

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