Most people don’t give much thought to the bones in their toes — until they break one. Clinically known as toe fractures, broken toes are fairly common injuries, and the smaller toes are more frequently broken than the big toe.
Of the 26 bones in your foot, 14 are in your toes. The big toes each comprise two bones and one joint, while the four smaller toes each have three bones and two joints. The bone closest to the foot is called the proximal, while the bone closest to the end of the toe is the distal. The middle bone is between the two; the big toe has no middle bone.
There are many possible causes of broken toes, but the most common include stubbing or banging your toe on a hard surface (such as a concrete curb or a couch leg), dropping a heavy object on it, or rolling it while walking or running. Diseases that affect bone density, such as osteoporosis, raise the risk of broken bones.
In general, there are many causes of foot pain.
Anyone can break a toe, but toe fractures happen most often among athletes and active people. Big toe fractures and sprains often are caused by repetitive pushing off the toe while running or jumping; this is known as “turf toe.”
Other types of toe fractures include stress fractures caused by repetitive activity, such as running or kicking, and a small chip fracture on the bone called an avulsion fracture.
Broken toe symptoms can range from mild to severe and may include:
- Sudden intense pain
- Significant bruising of the toe or toenail
- Swelling and/or tenderness
- Pain with weight bearing or walking
- Toe appears to be out of place
Especially with the smaller toes, the symptoms of a sprain and fracture can be very similar.
“It can be difficult to know if you’ve broken a toe or just severely sprained or bruised it,” says Jacob Braunstein, MD, an orthopedic surgeon specializing in foot and ankle surgery at Scripps Clinic Jefferson and Scripps Clinic Torrey Pines.
“It’s a common myth that if you can move your toe, it isn’t broken, but that is not always the case. You might be able to wiggle a broken toe or even walk on it, but movement can actually make it worse.”
If you suspect you’ve broken or sprained a toe, immediately apply an ice pack to it for 20 minutes to help decrease swelling and pain. Never apply ice directly to your skin; place a towel between the ice and skin to prevent frostbite. An over-the-counter pain medication, such as ibuprofen, can help relieve pain and swelling.
Then, make an appointment with your doctor to have it checked out.
“The majority of toe fractures can be managed by a primary care physician,” says Dr. Braunstein. “If your primary care physician has any further concerns, they can provide you with a referral to a specialist.”
Without appropriate medical treatment, broken toes may heal improperly and can cause chronic pain, arthritis of the toe joint, deformity of the toe or foot, movement restrictions and difficulty walking or wearing shoes.
“Many people believe there’s nothing a doctor can do for a broken toe, but that is not true,” says Tara Robbins, MD, a family medicine physician with expertise in sports medicine at Scripps Clinic Del Mar. “It’s important to have any possible fracture examined and treated as soon as possible to help reduce pain, prevent further damage and ensure proper healing.”
If the break is not severe, treatment for broken, sprained or bruised toes is often the same. In addition to recommending ice and rest, your doctor may show you how to splint an injured toe by taping it to the closest healthy toe for support. This is known as “buddy taping.”
A cast may be needed for toe bones that are dislocated or badly broken to immobilize them while they heal. Big toe fractures, which are more likely to involve joint or ligament damage, may require surgery.
Broken toes usually heal within four to six weeks.