When Toe Pain Becomes Serious: Signs You Might Need Surgery

Types and Signs of Foot Pain

Generally, pain is associated with swelling. When it comes to problems with your foot and a toe in general, it needs to be investigated by a foot specialist who may request blood tests or X-rays and ultrasound or MRI scans to come to a firm diagnosis before advising on treatment. Pain and swelling of the feet could affect the joints, the ligaments, or the tendons and may or may not really be related to injury and may also be a sign of more general health issues.

Heel Pain

The most common cause of heel pain is a condition called plantar fasciitis. In this condition, the ligament in the arch of the foot and particularly at the insertion of the heel bone becomes inflamed. It is estimated that 1 in 5 people will suffer from plantar fasciitis at some point in their life. It is often related to either poor footwear, putting on weight, or excessive activity. Typically, it will settle over a 6-week period, but will become chronic if it does not heal or does not settle. Your foot specialist would initially ask questions such as pain, which is worse first thing in the morning or after periods of rest, which are consistent with plantar fasciitis. They may request X-rays or ultrasound scan in particular to see whether there’s a thickening of the plantar fascial inflammation. They would assess for either tears or inflammation and advise accordingly.

Treatments can include stretching, ice, use of specialised insoles or orthotics to support the feet, especially in flat feet or if there are tight calves. Some physiotherapy could also help as home treatments such as night splints. However, should these treatments not work, then shockwave therapy increases the blood flow, and 3 to 5 sessions could help improve symptoms in 70 percent of patients and is a noninvasive method of treating plantar fasciitis. On rare occasions, an injection of steroids may be required. We occasionally put patients in a splint or a boot for a couple of weeks to allow the area to heal. If symptoms are severe, then MRI scan can determine whether there are other conditions such as calcaneal fractures, which is fracture of the heel bone, or nerve injury that is causing the problem. These are typically treated with immobilisation, possibly injection, and occasionally surgery.

Pain at the back of the heel could be related to the Achilles tendon where the heel bone. Conditions such as inflammation at this area or sometimes spur formation can cause pain. Treatments include shockwave therapy, injections, or surgery. Investigations with X-rays and MRI may be required prior to treatment.

Pain in the Bone of the Feet

Pain in the bone of the feet is often a result of either joint or ligament injury. The lesser metatarsal joints where the toes attached to the MTP joints become inflamed, these could be due to rheumatic conditions or due to injury or imbalance in the foot. Other causes include neuromas, which are swollen nerves in the intermetatarsal space, also known as a Morton neuroma commonly. Conditions such as bursitis, which is inflammatory sex, could also cause pain and inflammation. Treatment will depend on the investigations with X-rays and ultrasound MRI scans. If there is tear or plantar plate, which is the ligament of the ball of foot, then this may require surgery or rest initially. Steroid injections can help reduce some of the pain alongside insoles to support the feet better and distribute pressure.

Morton’s neuroma may often require surgery to remove the nerve that is damaged. This has long-term success in terms of resolving pain and discomfort in the area.

Toe Pain

Toe pain can result due to either arthritis of the lesser MTP joints or big toe joint. Occasionally, deformities such as hammertoes can cause pain in the interphalangeal joints, which are the middle joints of toes. These can often become deformed due to poor footwear fitting or damage due to injuries or repetitive injuries in many cases. Insoles could help alongside possible injections of steroids temporarily. However, in the long term, sometimes joint fusion or replacement surgery is required, sometimes resection of the joint and straightening of the toes.

Arthritis will need to be investigated with X-rays and MRI scans occasionally to be able to ascertain the best treatment plan. Sometimes there are metabolic conditions such as gout or rheumatoid arthritis, which will mainly require investigation with a rheumatologist.

Frequently Asked Questions

How do you know if your toe needs surgery?

If conservative treatments have failed, such as injections and insoles and footwear adaptation, then surgery may be the last resort. Your specialist would decide if that’s the case.

How do I know if my toe pain is serious?

This will need to be determined by a specialist after examination and careful consideration of all these tests and scans.

How do you know if toe surgery is expensive?

The cost of toe surgery very much will depend on the types of procedures and implants used to type your anaesthesia. Please inquire for a quote.