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