Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment questions for doctor specialist Home Care pain in adults pain in children pain skin wound toe ring removal using a cane using crutches warning signs Underlying Cause

Painful Toe after Injury Home Care

Home care for a toe injury includes:

  • Perform wound care as directed by your doctor.
  • Clean the skin gently:
    • Use mild soap and water.
    • Do not scrub the skin.
    • Dry the skin.
    • Apply an antibiotic ointment.
  • Apply cold compresses:
    • Wrap ice in a moist hand towel.
    • Do not apply ice directly to the skin.
    • Apply for 20-30 minutes, every 1-2 hours, for the first few days.
  • Elevate the foot.
  • Rest the injury.
    • Use a walker.
    • Use crutches.
    • Use a cane.
  • Apply splints or tape as directed by your doctor.
  • Buddy tape toes:
  • Nonsteroidal anti-inflammatory medications for pain:
  • Take prescribed medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Be aware of the common side effects that may be caused by your medication.

Painful Toe after Injury Pain in Adults

Medications commonly used to control pain and inflammation in adults with a toe injury include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Painful Toe after Injury Pain in Children

Common medications used at home for pain in children with a toe injury include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Painful Toe after Injury Pain Skin Wound

Minor cuts, abrasions and puncture wounds associated with a toe injury can usually be treated at home. Initial care includes:

  • Control bleeding with direct pressure.
    • Use a gauze or clean cloth directly on the wound.
    • Maintain the pressure for at least 10 minutes.
    • Do not keep looking at the wound.
  • Clean the wound with mild soap and water. Running water can help remove dirt.
  • You may gently dab the wound with hydrogen peroxide to remove clotted blood or debris. Do not scrub or re-injure the wound.
  • Be sure there is no dirt or other foreign material left in the wound.
  • A butterfly bandage can be used to close very small, clean cuts.
  • Apply an antibiotic ointment and a dry dressing.
  • Cover the wound with gauze or elastic bandage.
  • Keep the wound clean and dry.
  • Protect and rest the injured area.
  • Elevate the injured foot.

Ongoing care for minor skin wounds includes:
  • Abrasions may be cleaned 2-3 times a day with a mild soap such as dilute baby shampoo.
  • Dry the wound gently, and completely, with a clean towel or gauze.
  • Apply an antibiotic and a dressing as needed.
  • Foot wounds are especially prone to infection. Diabetics have the highest risk. Watch the wound carefully for signs of infection.

Tetanus Considerations
Tetanus shots (boosters) can be given up to three days after an injury, as long as you have had all your tetanus shots in the past. A tetanus booster seldom needs to be given right at the time of the wound. This is not an emergency and can be done in the doctor's office or clinic.

A tetanus shot is necessary right away if you have not had three tetanus shots at any time in your life.

You need a tetanus shot within three days for:
  • A dirty wound and you have not had a tetanus shot in the last five years
  • A clean, minor wound and you have not had a tetanus shot in the last ten years

Painful Toe after Injury Toe Ring Removal

Remove toe rings immediately after a toe injury, because it is difficult to remove the ring if the toe becomes swollen. Sometimes, the toe becomes so swollen that the ring must be removed with a ring cutter. The following will help you remove a toe ring from a swollen toe.

Ring Removal

  • Elevate the toe above the heart and apply a cold compress for 15-20 minutes.
  • Lubricate the ring:
    • Apply soapy water to the ring.
  • Ask another person to pull the skin tightly away from the ring, and then try to twist the ring off gently.
    • Stop if this causes pain or skin damage.
  • If this does not work, loop a piece of thin string or ribbon under the ring on both sides of the toe. Ask another person to grab the ends of both strings. Have the person pull equally on the ends of each string, while you gently twist the ring.

Reducing Toe Swelling
In order to reduce toe swelling, you may wrap a wide rubber band around the toe. Start at the tip of the toe and wrap towards the ring. Overlap the edges of the rubber band as you wrap the toe. After 5 minutes, remove the rubber band and try to remove the ring.

Do not wrap the toe with a rubber band if:

Seek medical care immediately for:

Painful Toe after Injury Using a Cane

Some patients with a toe injury may benefit from the use of a cane.

You might benefit from a cane if you have difficulty walking due to foot pain. If you are elderly, a cane might allow you to perform normal activities without assistance.

Proper Cane Length
The handle of your cane should reach to the crease in your wrist when you stand upright and the end of the cane is resting on the floor.

Using a Cane
Hold the cane in the hand on the side opposite the leg that needs support. When you step on the bad leg, the cane should be on the ground at the same time. For example, if your left leg is painful or injured, you should use the cane with your right arm. When you step with your left leg, the cane in your right hand and your left leg should be on the ground at the same time.

Follow these steps:

  • Position your cane one small stride ahead and step forward onto the bad leg. Place weight on your bad leg and the arm that is supported by the cane. Your elbow should be slightly bent as you support your weight.
  • Step forward with the good leg.

Climbing Stairs with a Cane
Climb one stair at a time and rest on one step before moving to the next step.

Follow these steps:
  • Grasp the handrail with the hand that is on the same side as the bad leg.
  • Place your weight on the bad leg and on the arm that is supported by the cane.
  • Step up to the next step with your good leg.
  • Transfer your weight to the good leg.
  • Move the cane and the bad leg to the step where you placed the good leg.
  • Support and stabilize yourself with your legs, the cane, and the handrail before moving to the next step.

Going down Stairs with a Cane
Go down one stair at a time and rest on one step before moving to the next step.

Follow these steps:
  • Grasp the handrail with the hand that is on the same side as the bad leg.
  • Place your weight on the good leg.
  • Place your bad leg and the cane on the step below.
  • Transfer your weight to the bad leg and the arm supported by the cane.
  • Move the stable leg to the step where you placed the cane and the bad leg.
  • Support and stabilize yourself with your legs, the cane, and the handrail before moving to the next step.

Painful Toe after Injury Using Crutches

Some patients with a toe injury will require crutches.

You must be able to support your entire weight on one leg in order to use crutches. Crutches allow you to walk without placing any weight on an injured or painful leg.

Proper Adjustment for Crutches

  • The top of your crutch should be 1-1.5 inches below your armpit as you stand upright and the crutch rests on the floor.
  • The hand grips should be even with your hip joint.
  • Your elbows should bend as you use the hand grips.

Non Weight Bearing Technique
  • Stand on the good leg while using the crutches for balance.
  • Hold the bad leg off the floor.
  • Begin your step as if you are going to step on the bad leg, but do not place any weight on this leg. Instead, place both crutches in front of you and place your weight on your arms.
  • Your arms are supported by the crutches as you grip the crutch handles.
  • The crutches should be placed on the floor at an angle away from the side of your body, in a shape like the upright arms of the capital letter, "A."
  • Your elbows should bend as you support your weight.
  • Gently push off with your good leg after the crutches are firmly planted on the floor. Swing your body forward between the crutches.
  • Rest the top of the crutches tightly against each side of your chest and continue to support your weight with your arms.
  • Do not rest your armpits on the tops of the crutches. This can cause nerve damage.
  • Place your good leg on the floor and allow it to completely support your weight. Swing your crutches slightly away from your body and forward. Place the crutches on the floor to prepare for the next step.
  • Focus on where you are walking -- do not look at your feet.

Partial Weight Bearing Technique
  • Stand on the good leg while using the crutches for balance.
  • Begin to step on the bad leg, but do not place your entire weight on this leg. Instead, place most of your weight on your arms.
  • Your arms are supported by the crutches as you grip the crutch handles.
  • The crutches should be placed on the floor at an angle away from the side of your body, in a shape like the upright arms of the capital letter, "A."
  • Your elbows should bend as you support your weight.
  • Gently push off with your good leg after the crutches are firmly planted on the floor. Swing your bad leg forward between the crutches.
  • Rest the top of the crutches tightly against each side of your chest. Continue to support your weight with your arms and the bad leg.
  • Do not rest your armpits on the tops of the crutches.
  • Place your good leg on the floor and allow it to completely support your weight. Swing your crutches slightly away from your body and forward. Place the crutches on the floor to prepare for the next step.
  • Focus on where you are walking -- do not look at your feet.

Climbing Stairs with Crutches
When climbing stairs, you should climb one stair at a time, completely resting for a moment on one step before moving to the next step.

Follow these steps:
  • Start by supporting your weight with your good leg and both crutches.
  • Place your weight on both of the crutches and move your good leg up to the next step.
  • Transfer your weight to the good leg.
  • Lift the bad leg and the crutches onto the same step where you placed the good leg.
  • Support and stabilize yourself with both crutches and the good leg before moving to the next step.

Going down Stairs on Crutches
When going down stairs, you should go down one stair at a time. Stop and rest for a moment on one step before moving to the next step.

Follow these steps:
  • Start by supporting your weight with your good leg and both crutches.
  • Place your weight on the good leg and place both of the crutches onto the next lower step.
  • Transfer your weight to both crutches.
  • Place the good leg onto the same step where you placed the crutches.
  • Support and stabilize yourself with both crutches and the good leg before moving to the next step.

Painful Toe after Injury Warning Signs

Notify your doctor if you have a toe injury and any of the following:

Continue to Painful Toe after Injury Underlying Cause

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