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Tuesday, July 10, 2012

Swollen, Yet NonPainful Toe: Email Advice

Dear Dr. Blake,
I have had a painless, swollen great toe for a few months. My family doctor does not know what it could be. The bottom of the toe is affected. The nail appears normal. I wonder if it could be due to wearing flip flops while working outside. Thank you for your time!


 Swelling with no pain in the foot is actually quite common. That swelling can be drainage even from the knee as gravity pulls swelling down, down, down. This is why it collects on the bottom of the toe.  Low grade trauma to the big toe with abnormal stress of flip flops is quite realistic. Golden Rule of Foot: Try to manipulate the swelling to see if it will go away. 

Your arsenal of weaponry is some elevation whenever possible at least above the ground a few inches on a stool, compression with Coban wrapping 24/7 for 1 week to check if helpful, ice pack 10 minutes twice daily, and any number of OTC anti-inflammatory medications or salves (advil, aspercreme, zyfamend, mineral ice, biofreeze, etc, etc, etc). So many of these, but I would start with something and apply 2 or 3 times per day.

 Why bother?

 Painfree swelling can become painful swelling if left untreated. I would be happy to look at a photo of both of your big toes if you want to send, as it may give me more clues. Whatever you decide to do, stick with it for 1 week, and then evaluate progress. If some, continue. If no progress or worse, changes will have to be made to the above process. It is typically logical. I hope this helps. Dr Rich Blake 


  1. That advice is largely nonsense. Swelling is much more likley to be an infection which if not treated (usually by antibiotics) could lead to cellulitis which itself can lead to blood poisoning. It needs to be assessed and treated immediately.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.