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Podiatry/Swollen/painful fourth toe


I caught my foot on the edge of my bed about five weeks ago. It immediately swelled up, bruised and was very painful. My ortho doctor x-rayed it about 3 days later when I was in for a follow up for another issue. The x-ray did not show a break. The toe and part of my foot are still swollen and discolored. It is difficult to put shoes on because of the swelling and painful to walk on and touch, especially at the base of the toe. Also, when I step I feel like something is under the ball of my foot. What could be causing this and should I go back into the doctor?


If the xrays were negative for a fracture, then it sounds like you sprained the toe.  Sometimes a toe sprain can cause just as much pain, swelling and bruising as an actual fracture.  If you still have moderate swelling that could be causing pressure to other soft tissue structures in your foot causing it to feel like you're walking on something under the ball of the foot.  However, I would see a podiatrist for a 2nd opinion and have an xray repeated.  Things should have started to resolve if it has been 5 weeks already since the initial injury.  There may have been a fracture in the toe that was non-displaced on the prior film which can be extremely difficult to see sometimes.  Until then I would buddy-splint the toe with sports tape.  Splint the 5th toe to the 4th toe to provide compression and stability until you can follow up with a doctor.  Please let me know if I can be of any further assistance.


Dr. Leslie Johnston, DPM

Tampa, FL
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Leslie Johnston


any podiatry related question. bunions, hammertoes, arthritis in foot and ankle, lumps and bumps, foot pain, ankle pain, neuromas, heel pain, plantar fasciitis, diabetic foot care, ulcers, neuropathy, charcot, ankle replacements, trauma, sports medicine, Achilles injuries, ankle sprains ect.


Currently working as an Associate for Advanced Podiatry in Tampa, FL. Finished 3 year surgical residency with additional certification in rearfoot and ankle reconstruction. Worked in wound care clinic at Veteran's Hospital using advance wound care techniques.



DPM degree earned from the Ohio College of Podiatric Medicine 2005-2009 completed 3 year podiatric medical and surgical residency training at James A. Haley VA 2009-2012. Board qualified status for American Board of Podiatric Surgeons in foot and rearfoot and ankle surgery 2012.

Awards and Honors
1st runner up in Resident case presentations at annual Science and Management Symposium 2012 Who's who among colleges and universities 2009

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