Definition
A sprain, a so-called distortion (lat. distorsio – twist) is an overstretching of a joint together with its joint capsule. Most sprains result from minor accidents in which the force applied is too low to cause more serious damage.
In addition to almost all other joints, a toe or even several can be affected by such an injury. The little toe, which often suffers injuries due to its marginal position, is particularly frequently affected. But all other toes can of course also be affected.
Causes
In contrast to other sprains (foot, wrist), the cause of a sprain of just one toe is usually not a sports accident, but an everyday injury. Patients often report that they bumped into a corner or edge when walking barefoot or did not notice obstacles in the dark in time. These situations are very painful, but usually not serious enough to break toes or other parts of the body or to cause permanent damage to a muscle, for example. Of course, many more accident situations are conceivable and even serious accidents can “only” result in a sprain. The causes of these injuries can be as varied as the patients who suffer them.
Symptoms
The classic symptoms of a sprained toe are severe pain in the affected joint – usually it is the joint at the transition from foot to toe – and swelling in the same place. Patients often also complain of pain when walking and a change in the functionality of the toe. In addition, bruising can occur on or under the toe either immediately or after a few hours or days. On the other hand, the toe should not protrude at unnatural angles from the foot and open wounds would also be very unusual.
Treatment – What to do?
So what should you do if you sprain your toe? For the time being, the PECH rule also applies here – although, as mentioned, it is usually not a sports injury. Consistent cooling and elevation of the foot relieves pain on the one hand and can effectively reduce the development of large bruises and swellings on the other.
Subsequently, compression with elastic bandages or tape bandages is recommended. It is important that the bandage is tight enough to provide support, but not so tight that it constricts the blood vessels or nerves of the toe. If you experience cold, pale toes or an unpleasant tingling sensation under or behind the bandage, it should be removed immediately and reapplied.
During the days following the accident, you should always put your foot up and relieve the pressure. In case of very severe pain, a so-called non-steroidal anti-inflammatory drug (NSAIDs) such as ibuprofen or diclofenac can be taken. However, this should only ever be taken for a short period of time and/or in consultation with a doctor, as these drugs can of course also cause side effects.
If the pain is moderate, it is advisable to use an analgesic ointment (e.g. with diclofenac) in addition to the above-mentioned treatment measures. This is available over the counter from the pharmacy and can be applied directly to the injured area. The anaesthetic active ingredient alleviates the pain and – depending on the preparation – may even cool it down additionally.
In addition to the use of a pain ointment, some doctors recommend therapy with blood circulation-promoting ointments. Applied after the first 48 hours (important – never before), they should promote the blood flow and thus the removal of possible bruising and swelling, and provide nutrients and energy to regenerate the injured structures. Whether and how exactly this effect can occur is not undisputed, however, some doctors do not certify these ointments as having any other effect than the placebo effect, which makes patients believe in a quick healing.
In addition to bandages made of elastic bandages, taping a sprained toe can also be a good way to stabilize and immobilize the toe. Relatively narrow, not too thick sports tape, which is wrapped around the injured toe like a ring, is best suited for this purpose. Under certain circumstances, one or two wider strips (so-called reins) can be stuck in the direction of the metatarsus to provide additional stabilization.
As with elastic bandages, the feeling in the affected toe should be checked before and after applying the tape. Is the toe still warm and pink despite the tape? Or is the patient already complaining of sensations, tingling and numbness?The latter are clear indications that the tape dressing is too tight and should be loosened and reapplied as quickly as possible.