A dislocated toe occurs when the bones in the toe become misaligned, often leading to significant discomfort and mobility issues. Common symptoms include intense pain at the site of the injury, noticeable swelling, and bruising. The affected toe may appear deformed or out of place, and there may be difficulty moving it or walking without pain. Several factors contribute to dislocated toes, with sports injuries being a leading cause. Activities involving running, jumping, or sudden changes in direction can put excessive stress on the toe joints. Also, accidents such as stubbing the toe or dropping a heavy object on it can lead to dislocation. If you have sustained an injury that may have dislocated your toe, it is suggested that you promptly contact a podiatrist who can provide an accurate diagnosis and treatment.

Toe pain can disrupt your daily activities. If you have any concerns, contact Kent DiNucci, DPM of Ankle and Foot Clinic . Our doctor can provide the care you need to keep you pain-free and on your feet.

What Causes Toe Pain?

Most severe toe pain is caused due to a sports injury, trauma from dropping something heavy on the toe, or bumping into something rigid. Other problems can develop over time for various reasons.

Toe pain can be caused by one or more ailments. The most common include:

• Trauma
• Sports injury
• Wearing shoes that are too tight
• Arthritis
• Gout
• Corns and calluses
• Hammertoe
• Bunions
• Blisters
• Ingrown toenails
• Sprains
• Fractures (broken bones)
• Dislocations

When to See a Podiatrist

• Severe pain
• Persistent pain that lasts more than a week
• Signs of infection
• Continued swelling
• Pain that prevents walking

Diagnosis

In many cases the cause of toe pain is obvious, but in others, a podiatrist may want to use more advanced methods to determine the problem. These can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.

Treatment

Treatments for toe pain and injuries vary and may include shoe inserts, padding, taping, medicines, injections, and in some cases, surgery. If you believe that you have broken a toe, please see a podiatrist as soon as possible.

If you have any questions please feel free to contact our office located in Omaha, NE . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

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Pes planus, commonly known as flat feet, is caused by the loss of the medial longitudinal arch of the foot. This results in the entire sole making contact with the ground, leading to a flat appearance. Various factors contribute to the development of pes planus. Genetic predisposition plays a significant role, as some individuals inherit a tendency for weak arches. Additionally, obesity places excess strain on the feet, weakening the arch over time. Other causes include injuries or conditions that damage the tendons supporting the arch, such as posterior tibial tendon dysfunction. Chronic conditions like diabetes and rheumatoid arthritis can also contribute to the loss of the arch. If you have flat feet, it is suggested that you are under the care of a podiatrist who can offer you comfort options and help you to manage this condition.

Flatfoot is a condition many people suffer from. If you have flat feet, contact Kent DiNucci, DPM from Ankle and Foot Clinic . Our doctor will treat your foot and ankle needs.

What Are Flat Feet?

Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.

Conditions & Problems:

Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.

Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.

Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.  

Symptoms

• Pain around the heel or arch area
• Trouble standing on the tip toe
• Swelling around the inside of the ankle
• Flat look to one or both feet
• Having your shoes feel uneven when worn

Treatment

If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle. 

If you have any questions please feel free to contact our office located in Omaha, NE . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Flat Feet

Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. This is an older term used by people who typically don't understand that most neuropathy in the lower extremity is due to a nerve damage or possible entrapment. 

Doctors will frequently tell patients that there is nothing that can be done for them.  In fact, this means that this doctor doesn't know what can further be done for that patient.  Most traditional doctors and most specialists are not specifically trained in how to diagnose and treat peripheral neuropathy.  There are only a handfull of specialists in Omaha who are well-trained and versed in diagnosing and treating peripheral nerve issues in the lower extremity and Dr DiNucci is one of the elite.  He has trained with the best peripheral nerve surgeons in the world.  He continues to educate the public, medical students, residents and other health care practioners alike on nerve disorders.  Moreover, he is always in learning mode and looking out for another way to help treat difficult cases.  

Peripheral nerve specialists are a different world of physicians.  They are always learning and continuing to better the methods currently used and not afraid to push the boundaries and explore new ways to help people in chronic pain.  Most podiatrists, and other specialists do not have the same training as Dr. DiNucci in relating to peripheral nerves and he is one of the best at diagnosing and helping people in chronic pain.  

Nerve Damage

Nerve damage may be a result of a nerve entrapment in the feet, legs, hip or spine. It may occur as a result of the swelling of the nerve or tightening of a tunnel, or possibly a traction injury after trauma. Nerves may degenerate as a result of a deficiency or toxin and sometimes we can figure this out and sometimes these causes are very costly and difficult to diagnose. Deficiencies, toxins, traction injuries, entrapment injuries, trauma, a cut or stuck nerve will cause a nerve to become dysfunctional and the symptoms will present as burning, tingling numbness or pain. There are other symptoms but these are the most common.   

The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.

Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the lower extremity.  Diagnostic injections are sometimes used to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans might be used to look for abnormalities.  .Rarely, do nerve conduction tests or EMG's help but sometimes in specific cases they are helpful.  

Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area.  However, many other times the nerve needs to be released from a tight tunnel or repaired after an injury.  Many times the sooner this occurs, the better the result.  Surgery is outpatient and in most cases the patient is walking right away and no crutches or knee walkers are required.  

Physical therapy is useless to a nerve problem.  If the nerve is not working, by moving the muscles more, the nerves are not going to be stimulated to regenerate. 

If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing a nerve problem and Dr. DiNucci is the one you should be talking to. 

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion pain. 

Dr DiNucci is knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. Dr. DiNucci may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the bone behind the toe and this is what allows the big toe to move back into a normal, straight position. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped. They develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot.

Corns are often confused with a callus, but there is a difference between them. Corns can be raised bumps that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. 

Removing the dead skin that has built up is the key in treating corns. 

Another way to treat corns and help prevent their return is by using orthotic inserts like The Foot Chair adjustable orthotic.  This orthotic insert fits right into your shoes and adjusts the way your foot fits into your shoes. By being able to change the orthotic and make it higher or lower, you can take off more pressure from areas that have pressure and are developing a corn or callus. This will lower your chances of getting corns, and eliminate current corns.

Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.

To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area.

Frequently, people fall for advertising gimmicks such as Memory Foam and other gel or foam products that increase cushion. Your foot will fall through cushion and foam and you won't take any pressure off the areas that are developing a corn or callus.  Therefore, you should stay away from that type of shoe or insert.  

The forefoot is composed of five metatarsal bones and fourteen phalanges. Each toe has three bones, except for the big toe which only has two. Our toes play an essential role to the walking process, which is why a broken toe could seriously disrupt one’s ability to move around. Toe fractures are common and can be very painful. Fortunately, these injuries rarely require surgery and usually heal with rest and a change in activity.

Broken toes typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. Traumatic toe fractures may be categorized as either minor or severe fractures. At times, one may hear a “pop” or “crack” sound when the bone breaks. Common symptoms of a traumatic toe fracture include pain, throbbing, bruising, swelling, and redness.

Another type of fracture is usually of the metatarsal, which is behind the toes and these bones can have stress fractures. These injuries usually appear in the form of small hairline breaks on the bone. Stress fractures develop after repetitive activity. 

If you suspect that you have a broken toe, you should make an appointment with Dr. DiNucci. He will likely diagnose you by performing a physical exam and an X-ray. Treatment for a broken toe may include the R.I.C.E. method, buddy taping, surgery, or antibiotics. The R.I.C.E. method (Rest, Ice, Compression, and Elevation) is a common treatment method for many injuries because it decreases pain. Buddy tapping involves wrapping the injured toe next to an adjacent toe to keep it supported and protected. These two methods have proven to be effective in the healing process for toe fractures. The estimated healing time for a broken toe is approximately four to six weeks. If the injury becomes infected or requires surgery, the estimated healing time may take eight weeks or more. 

An ingrown toenail is a toenail that grows curved into the nail bed, causing pain and swelling. Ingrown toenails can worsen and cause drainage, turning into a serious infection.

Keep in mind that the toenail is an appendage of your skin just like your hair.  Once it is laid down it is dead and therefore has no immune capabilities so bacteria will normally inhabit it, just as they colonize normal skin and hair.  Therefore, when the ingrown nail has broken the skin it will 'seed' bacteria into the tiny open wound and cause an inflammatory reaction and possible infection.  Essentially, the nail is acting like a splinter.  The splinter is embedded into the soft tissue and causing pain or an infection.  Once the splinter is removed from the area of the open wound, the soft tissue can heal. 

Ingrown toenails can be preventable with certain measures. If you have already developed an ingrown toenail, soak the affected toe in warm water. This will alleviate the pain and help dilute any bacteria that may be trying to cause an infection. Antibiotic soap or Epsom salts may be added to further help the relieving process and avoid infection. Placing cotton beneath the affected area is an old old method that was used when nothing else was available.  However, cotton is not good to put in an open wound and can cause problems since some may remain in the soft tissue.  The old doctors used to thing this would 're-train' the nail  and may help the toenail grow upwards and not into the nail bed.  This is old school medicine and completely false.  Do not do this. 

VERY IMPORTANT:  It should also be noted that in many older text books they will teach the doctors or PA, or NP to remove the entire nail for an ingrown nail.  Infected or not. THIS IS INCORRECT AND A BAD TREATMENT CHOICE.  They will many times remove the nail.  This is completely false and in most cases the nail never needs to be removed completely.  Only a small sliver of the nail needs to be removed in order to take the loose nail away from the infection or th ingrown curved part.  DO NOT HAVE YOUR NAIL REMOVED unless there is no other choice.  Dr. DiNucci is very conservative regarding this and normally will not take a nail off but instead just the corner that has been affected. 

Dr. DiNucci should be contacted immediately if the pain becomes so serious that it prevents you from doing your everyday activities. If a red streak running up your leg appears or if you suspect your infection has spread, contact Dr. DiNucci immediately and convey this to his staff and they are trained to get you in to see him as soon as possible. Fast treatments can be undertaken to lessen your pain and have you walking comfortably.

To prevent the nail from growing back, medication will be placed directly into the nail bed. This procedure would be performed under local anesthesia and is a faster method to alleviate discomfort from an ingrown toenail. Post-procedure directions will have you stay off the affected foot for a day or so. Afterwards, normal activities can be resumed.  

Sever's disease, also known as calcaneal apophysitis (or growth plate in the heel), is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.

Sever's disease occurs when the child’s growth plate on the back of the heel, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back and bottom of the heel and difficulty putting any weight on the heel. 

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running or after after activity.  Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. 

The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful and also incorporating proper arch support for the heel and arch.  The Foot Chair arch support is the most effective arch support available on the market.  Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by Dr. DiNucci.  

An exercise known as foot curling is a wive's tale some people will talk about using to treat the heel pain.  These useless exercises have no bearing on a growth plate that is inflamed and will not promote healing.  Don't waste your time on these and instead rest the foot.

Treatment methods using the arch supports and anti-inflammatories can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. The child also needs to discontinue all sports and recreational activities during this healing period.  

Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.

Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains. 

An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.

Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.

Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.

Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.