How to Treat a Stubbed Toe

Assess the condition of the toe immediately after the injury. The first step in treating a stubbed toe is to check the extent of the damage. Carefully remove the shoes and socks from the injured foot. Inspect the injured toe and handle it gently to avoid causing additional harm (you may want to ask a friend for assistance). Look for these signs:

• The toe appears "bent" or "misaligned"
• Bleeding
• The toenail is cracked or detached
• Bruising
• Swelling and/or color change
• Depending on any signs observed (if any), the treatment method may vary. Specific recommendations can be found below:
• If removing the shoes and socks is too painful, it may indicate a fracture or sprained toe and/or foot. While not dangerous, it is still important to see a doctor for proper treatment.

Clean and disinfect the scratch or tear on your toe. If you notice any signs of skin tears on the toe, it’s important to clean the area quickly to prevent infection. Signs include cuts, scratches, or nail splits. Gently wash the toe with soap and warm water. Pat it dry with a clean towel or tissue. Then, apply some antibacterial cream to any cuts on the skin. Use a clean bandage to protect the toe.

• Change the bandage daily as the toe heals.
• Refer to the article on How to Clean a Wound for a detailed, step-by-step guide.

Apply ice to reduce swelling. Almost all stubbed toe injuries result in some swelling and discomfort. This can make movement difficult and even more painful. Fortunately, you can easily reduce the swelling by applying cold. There are various ways to apply cold, such as using a gel ice pack, ice cubes in a bag, or even an unopened frozen vegetable bag.

• Whatever you use to ice the injury, wrap it in a cloth before applying it to the skin. DO NOT place the ice directly on the skin. Prolonged contact between ice and skin can cause further damage, making the injury worse.
• In the first 24 hours after stubbing your toe, ice for about 20 minutes each hour when awake. After that, continue icing 2-3 times a day until the pain subsides.
• Read the article on How to Apply Cold Therapy for more details.

Avoid putting pressure on the injured toe. Even regular daily activities can be painful if you're walking on the stubbed toe. To reduce pain and further swelling, shift some of your weight onto your heel while standing and walking. However, this may make it harder to keep balance, and putting all your weight on your heel can cause heel pain over time. Aim to reduce pressure just enough on the toe to avoid pain while walking.

• Once swelling in the stubbed toe has decreased, you can use a thin cushion (e.g., gel insoles) to ease walking pain.
• If pain persists for 1-2 hours, refrain from physical activities like sports for a few days until the pain subsides.

Ensure your shoes have enough space for your injured toe. Tight shoes can aggravate the swelling and discomfort of a stubbed toe. If possible, choose wide and comfortable shoes after the injury to protect your toe from added pressure. If you don’t have shoes to replace the tight ones, you can loosen the laces.

• Open-toed shoes, like sandals and flip-flops, are the best choice because they don’t put pressure on the toes and provide space for easy icing and bandage changes.

Treat persistent pain with over-the-counter medication. If the pain from a stubbed toe doesn’t subside on its own, over-the-counter pain relievers can provide temporary relief. There are many options available, including acetaminophen (Paracetamol) and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn), which are widely available at most pharmacies.

• Be sure to follow all dosage instructions on the medication packaging. Over-the-counter medications can have harmful side effects if taken in large doses.
• Do not give aspirin to young children.

Support the injured toe with bandaging. Wrap the bandage around the affected toe and the neighboring one to create a supportive 'partner' for the injured toe. You can place cotton pads between the toes to prevent moisture buildup in this area.

• Change the cotton pads daily.

Elevate the injured toe. Another great way to reduce swelling is to elevate the injured toe higher than the body when sitting or resting. For example, you can use a few pillows to prop up the toe while lying down. Elevating the swollen toe above the body makes it harder for the heart to pump blood to the toe, allowing the blood to gradually drain from the swollen area and helping to reduce swelling. Although it's not possible to elevate the injured toe while standing or walking, you can take advantage of sitting or lying down time to do so for extended periods.

Be cautious of persistent pain and inflammation. As mentioned in the introduction, most cases of stubbed toes are not serious. However, a clear sign that the problem may be worsening is when the toe does not seem to improve quickly. Pain that does not subside in the time it takes for typical bruising to heal can be a sign of an underlying issue that requires special treatment. Specifically, you should monitor the following signs:

• Pain that does not diminish within 1-2 hours.
• Pain recurring every time pressure is applied to the toe.
• Swelling and/or inflammation that makes walking or wearing shoes difficult for several days.
• Color changes resembling bruising but not improving after several days.

Watch for signs of a broken toe. A particularly severe stubbed toe may lead to a fracture (broken toe). In such cases, an X-ray, a cast, or a foot splint may be required. Signs of a fracture include:

• A "crack" or "snap" sound at the moment of injury.
• The toe appears "bent", "twisted", or "curled".
• Inability to move the injured toe.
• Persistent pain, swelling, and bruising.
• Note that many cases of broken toes do not prevent the person from walking. The ability to walk is not a sign that the toe is not broken.

Monitor signs of subungual hematoma (blood under the nail). A common injury from stubbing your toe is blood accumulating beneath the toenail. The pressure between the pooled blood and the nail can lead to inflammation and prolonged swelling, which delays healing and causes discomfort during recovery. In such cases, a doctor may drill a small hole in the toenail to drain the blood and relieve pressure. This procedure is called bone trephination.

Check for signs of a cracked or broken nail. A toe injury that causes part or all of the nail to detach from the nail bed can be extremely painful. While some cases can be treated at home, a visit to a healthcare provider will ensure you receive proper care to relieve pain, protect the wound, and prevent infection (treatment options might not be available at home).

• Additionally, if the injury is severe enough to cause nail damage, it may also result in a broken toe or other issues that require medical attention.

Watch for signs of infection. Generally, you can treat a stubbed toe at home, but it’s important to monitor for signs of infection. If you notice increasing pain, redness, swelling, numbness, or sharp pain in the toe, or if you develop a fever, you should see a doctor as soon as possible.

If the toe injury seems serious, see a doctor. Any of the issues mentioned above, including a broken toe, subungual hematoma, or nail injury, are reasons to seek medical attention. A healthcare professional can use X-rays and other tools to accurately diagnose the problem. Furthermore, doctors and nurses are trained to guide you on how to protect the toe during healing. However, it’s important to remember that most stubbed toes do not require medical care. But if you feel your case is serious, don’t hesitate to visit a doctor.

• Always follow your doctor’s advice rather than relying on online recommendations. If your doctor’s advice contradicts what you’ve read in this article, always listen to your doctor.

• Take a break from your activity after stubbing your toe, even if there’s no clear indication that the injury is serious. Mild swelling from a stubbed toe can make it more susceptible to being stubbed again.
• The reason it’s difficult to determine whether a stubbed toe is serious is because the foot contains highly sensitive nerve endings. In other words, even a minor injury to the toe can feel as painful as a more severe one. Therefore, it’s especially important to monitor for signs of a more serious injury after stubbing your toe.