Toe and Forefoot Fractures - OrthoInfo - AAOS (2023)

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Toe and forefoot fractures are quite common. Fractures can result from a direct impact on the foot, such as accidentally kicking something hard or dropping a heavy object on the toes. They can also be the result of overuse and repetitive stress in high-impact sports such as running, football and basketball.

Although a broken bone in the toe or forefoot can be quite painful, it rarely requires surgery. In most cases, the fracture will heal with rest and a change in activity.


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Forefoot bones.

The front has 5 metatarsals and 14 phalanges (toes). There are 3 phalanges in each finger, except for the first finger, which normally has only 2.

All the bones in the forefoot are designed to work together as you walk. Breaking or breaking any of these bones can be painful and affect the function of the foot.


Toe and forefoot fractures are often caused by trauma or direct bone damage. Fractures can also develop after repeated activity rather than a single injury. This is called a "stress fracture".

Breakage can be either:

  • not moved,where the bone is broken but the ends of the bone are together
  • displaced,where the ends of the broken bones are partially or completely separated

Fractures can also be divided into:

  • closed fractures,where the skin is not damaged
  • open fractures,where the skin is damaged and the wound reaches the bone. Open fractures are especially dangerous because when the skin is damaged, bacteria can enter the wound and cause bone infection. Immediate treatment is necessary to prevent infection.


The most common symptoms of a fracture are pain and swelling. Other symptoms may include:

  • Bruising or discoloration that extends to nearby parts of the foot
  • Pain with walking and exertion

First aid

If you think you have a fracture, it is important to see your doctor as soon as possible. An untreated fracture can lead to chronic foot pain and arthritis and affect your ability to walk.

(Video) 08 Foot fractures & dislocations: Forefoot fractures

While you are waiting for your doctor's appointment, do the following:

  • Apply ice to reduce swelling.
  • Lift your foot as high as possible.
  • Limit the load.
  • Lightly wrap the foot with a soft compression bandage.

Medical examination

Medical examination

When you see your doctor, he or she will interview you to find out how your foot was injured and ask about your symptoms. Your doctor will examine your foot and may compare it to the foot on the opposite side.

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Your foot may be swollen and discolored after a fracture.

During the examination, the doctor will pay attention to:

  • Edema
  • Tenderness at the fracture site
  • Bruising or discoloration - Your foot may be red or petechial ("black and blue")
  • Distortion
  • Skin abrasions or open wounds
  • Loss of feeling - an indication of nerve damage

Imaging tests

Your doctor will also order imaging tests to help diagnose the fracture.

x-rays.X-rays provide images of dense structures such as bones. An X-ray can usually be taken in a doctor's office.

Most fractures can be seen on a routine X-ray. However, a stress fracture may begin as a small break in the bone and may not be visible on the first X-ray.

In many cases, a stress fracture can only be seen after several weeks, when it has actually started to heal and a form of healing bone, called callus, develops around the fracture site.

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(Lewy)A recent stress fracture of the third metatarsal is barely visible on this radiograph (arrow).(Normal)A few weeks later a callus forms at this point and the break can be seen more clearly.

Magnetic resonance imaging (MRI) scans.If your doctor suspects a stress fracture but can't see it on an X-ray, he or she may recommend an MRI.

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More sensitive than an X-ray, an MRI can detect changes in the bone that may indicate a fracture. Unlike an X-ray, there is no radiation with an MRI.


Treatment of a toe or forefoot fracture depends on:

  • Location of the injury
  • Type of fracture

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Even though the toes are small, toe injuries can often be quite painful.

A broken toe can result from direct trauma, such as dropping a heavy object on the forefoot or accidentally kicking or bumping into a hard object. A fracture can also occur if you accidentally hit the side of your foot against a piece of furniture on the floor – and your toes get twisted or pulled sideways or in an awkward direction.

The proximal phalanx is the big toe bone closest to the metatarsal bone. Because it is the longest of the toe bones, it is the most prone to fracture.

A broken toe may become swollen, sore and discolored. If the bone is out of place, your toe will look deformed.


Most broken fingers can be healed without surgery. For a few days, weight on the injured finger may be painful. But when the pain subsides, you can start lifting weights when you feel comfortable. During this time, it may be helpful to use a shoe that is wider than usual.

Sticking a broken toe to an adjacent toe can sometimes help relieve the pain.

If the bone is out of place and the toe appears deformed, the doctor may need to manipulate or reduce the fracture. This procedure is most often performed in a doctor's office. You will be given a local anesthetic to numb your foot, and then your doctor will reattach the fracture to straighten your toe.

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(Lewy)In this radiograph, a fracture of the proximal phalanx of the fifth finger (arrow) resulted in a deformity of the finger.(Normal)The bones in the bent finger have been manipulated (reduced) back into place.

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Metatarsal fractures

The metatarsals are the long bones between the toes and the middle of the foot. Each metatarsal bone has the following four parts:

  • Head - which forms a joint with the base of the finger
  • Neck - The narrow area between the head and body
  • The shaft is the long part of the bone
  • Base - which forms a connection with the metatarsal

Fractures can occur anywhere in the metatarsal bone, but are most common in the neck or shaft of the bone.

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(Lewy)Four parts of each metatarsal bone.(Normal)The X-ray shows a fracture of the second metatarsal shaft.

Like toe fractures, metatarsal fractures can result from a direct impact on the forefoot or a sprain injury.

Some metatarsal fractures are stress fractures. Stress fractures are small cracks in the bone's surface that can widen and enlarge over time.

Stress fractures are usually caused by repetitive activities or pressure on the forefoot. They are common in runners and athletes in high-impact sports such as football, soccer, and basketball.

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High-impact activities such as running can lead to stress fractures of the metatarsal bones.

A stress fracture can also be caused by a sudden increase in physical activity or a change in exercise routine.


Most metatarsal fractures can heal with an initial period of elevation and limited weight bearing. This is followed by progressive loading, as tolerated, in a cast or walking boot. Surgery is not often necessary.

However, if you have broken several metatarsal bones at the same time and your foot is deformed or unstable, you may need surgery.

During the procedure, the doctor will make an incision in the foot and then insert pins or plates and screws to hold the bones in place while they heal. This is called internal fixation.

The operation may be delayed for several days to allow the swelling of the foot to subside. But if you have an open fracture, your doctor will perform the operation more urgently.

Fifth metatarsal fractures

The fifth metatarsal is a long bone on the outside of the foot. Injuries to this bone may act differently than fractures to the other four metatarsal bones.

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The most common fracture of the fifth metatarsal occurs through the base of the bone. This usually occurs as a result of an injury where the foot and ankle are twisted downwards and inwards.

In this type of injury, the tendon that attaches to the base of the fifth metatarsal can stretch and pull a piece of bone away from the base. Because a fragment is torn away from the rest of the bone, this type of injury is called an avulsion fracture.

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X-ray shows an avulsion fracture at the base of the fifth metatarsal (arrow).

An avulsion fracture is sometimes called a "ballerina's fracture" or a "dancer's fracture" because of the pointe position that ballet dancers assume when standing on their toes.

A Jones fracture is a horizontal or transverse break at the base of the fifth metatarsal. It is one of the most common foot fractures and has unique characteristics that make it more likely to require surgery.


Most fifth metatarsal fractures can be treated with weight bearing if tolerated and immobilization in a cast or walker. However, if an avulsion fracture results in a large displacement of the fracture fragment, it may be necessary for the physician to have an open reduction and internal fixation with intramedullary plates and/or screws.

Appropriate treatment depends on the location of the fracture, the amount of displacement (displacement of the two ends of the fracture), and the patient's activity level.

Because Jones fractures are in an area with poor blood supply, they may take longer to heal. In some cases, a Jones fracture may not heal at all, a condition called nonunion. When this happens, surgery is often required. Concerns about delayed healing and/or high activity demands may lead your doctor to also prescribe surgery for an acute Jones fracture.

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(Lewy)X-ray shows a Jones fracture at the base of the fifth metatarsal (arrow).(Normal)An intramedullary screw was used to hold the bone in place while it healed.

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Back to health

It can take 6 to 8 weeks for a broken finger to heal.

Metatarsal fractures usually heal within 6 to 8 weeks, but may take longer. Your doctor will take additional X-rays to make sure the bone is properly aligned and healing. Even with proper healing, the foot can be swollen for months and finding a comfortable shoe can be difficult.


Your doctor will tell you when it is safe to resume activity and return to sports. However, if you experience pain, you should stop the activity and notify your doctor. Returning to activity too soon can put you at risk of re-injury.


What is the difference between a broken toe and a fractured toe? ›

Is there a difference between a fractured toe and a broken toe? Actually, there's no difference whatsoever! A fracture and a break are the exact same thing, even though one may sound different or even more severe than the other. For the sake of simplicity, let's refer to a fractured toe as that: a fractured toe.

What's the most painful bone to break? ›

The Femur is often put at the top of the most painful bones to break. Your Femur is the longest and strongest bone in your body, running from your hip to your knee. Given its importance, it's not surprising that breaking this bone is an incredibly painful experience, especially with the constant weight being put on it.

How long does a 5th metatarsal Jones fracture take to heal? ›

The fracture may take 6 weeks to several months to heal. It is important to give your foot time to heal completely so that you don't hurt it again. Do not return to your usual activities until your doctor says you can.

What is the most common toe fracture? ›

Out of the five toes (also known as digits of the feet) the pinky toe is the most commonly broken toe with the fracture often occurring at the base of the toe. Your toes make up a portion of your foot referred to as the forefoot.

Do they do anything for a fractured toe? ›

Usually, treating a broken toe involves taping it to the next toe. But if the fracture is severe — especially if it's in the big toe — proper healing might require a cast or even surgery to heal well.

Should a broken toe be splinted? ›

If you have a severe injury, you should seek medical help. Injuries that involve the big toe may need a cast or splint to heal. In rare cases, tiny pieces of bone can break off and keep the bone from healing properly. In this case, you may need surgery.

What is the hardest fracture to recover from? ›

10 Worst Bone Fractures Ever
  1. Femur. The femur is the only bone in the thigh and is the longest and strongest of all bones in the body. ...
  2. Spine. The spinal column protects the spinal cord. ...
  3. Skull. ...
  4. Wrist. ...
  5. Hip. ...
  6. Rib. ...
  7. Ankle. ...
  8. Pelvis.
Apr 30, 2021

What broken bone takes the longest to heal? ›

Most fractures heal in 6-8 weeks, but this varies tremendously from bone to bone and in each person based on many of the factors discussed above. Hand and wrist fractures often heal in 4-6 weeks whereas a tibia fracture may take 20 weeks or more.

What is the easiest bone to break in your foot? ›

The metatarsal bones are some of the most commonly broken (fractured) bones in the foot. There are five metatarsal bones in each foot. They are the long slim bones which run the length of the foot to the base of the toes.

Do you need a boot for a 5th metatarsal fracture? ›

This is a common fracture. You will be given a removable boot to wear to support your foot; this should be used for two to six weeks to enable you to walk more comfortably whilst the injury heals. You only need to wear this when standing or walking, you can remove it at rest, at night and when bathing or showering.

Can you wear a walking boot with a Jones fracture? ›

A Jones fracture occurs in the zone between the shaft and the tip of the bone. This fracture is different from other fractures in the little toe. For example, ankle sprains cause avulsion fracture of the 5th Metatarsal. Therefore, we treat these fractures with a walking boot.

How long are you in a boot with a Jones fracture? ›

Farber, who specializes in foot and ankle surgery, said, “for a true Jones fracture, it is recommended that patients be placed in a short leg cast or controlled ankle motion (CAM) boot, and remain non-weight bearing for approximately six weeks.

How can I speed up the healing of a broken toe? ›

Rest, ice, compression, and elevation (RICE): The RICE method is useful for many types of injuries, including broken toes. It can decrease pain and help the toe heal faster. This may be all a person needs to treat a minor toe fracture.

What is the fastest a broken toe to heal? ›

Most broken toes will heal on their own with proper care at home. It can take 4 to 6 weeks for complete healing. Most pain and swelling will go away within a few days to a week. If something was dropped on the toe, the area under the toenail can bruise.

What is the fastest way to heal a 5th metatarsal fracture? ›

You can improve your recovery time by:
  1. Elevating your foot while seated.
  2. Icing your foot for 20 minutes a day as needed, after your injury and before treatment.
  3. Keeping weight off your foot for the time recommended by your provider.
  4. Quitting smoking and/or using tobacco products which can help speed your healing time.
Dec 29, 2021

Can you wiggle your toes with a broken metatarsal? ›

A severe fracture will limit motion due to swelling and pain, but a non-displaced single fracture of most bones of the foot and ankle will allow full motion of the extremity, and this is certainly the case in stress fractures.

How long should I buddy tape a broken toe? ›

Your broken toe may need to be buddy-taped for 2 to 4 weeks to heal. Rest and protect your toe. Do not walk on it until you can do so without too much pain.

Should a broken toe still hurt after 2 weeks? ›

Your toe is likely to be tender and swollen, even after a few weeks. You'll likely need to avoid running, playing sports, or walking long distances for one to two months after your injury. Recovery time can be longer if the break is in one of the metatarsals.

What should you avoid with a broken toe? ›

  • do not strap up your toe if it's pointing out at an odd angle or you have hurt your big toe – get medical advice.
  • do not put ice directly on your skin.
  • do not walk or stand for long periods.
  • do not wear tight, pointy shoes.
  • do not play any sports like football, rugby or hockey for 6 weeks or until the pain eases.

What toe is the most important? ›

It probably is no surprise that your big toe is the most important when maintaining balance and bearing body weight. Your big toes bear just about 2 times the amount of weight as all your other toes combined! It still should not shock you that the pinky toes are the least important.

How do you wear shoes with a broken toe? ›

Because the pressure could cause you pain, or even delay your healing. Now, some people can get away with wearing regular shoes. But, if this is the case for your injury, you should choose a low heeled or tennis shoe. Something that's stable and comfortable to help your healing.

What fracture never heals appropriately? ›

This is called a malunited fracture. A nonunion, delayed union, or malunited fracture may occur in any bone, but these conditions are most common in the humerus, or upper arm, and the tibia, or lower leg.

Does a fracture hurt worse than a break? ›

Broken bones happen all the time, and sometimes people even suffer fractures. The terms “fracture” and “broken” are both scary when it comes to bones. While one isn't necessarily worse than the other, they can both be painful, dangerous, and a cause to worry.

What are the 5 stages of fracture healing? ›

  • Five Stages of Healing a Fracture.
  • First stage: Hematoma formation.
  • Second stage: Development of fibrocartilaginous callus.
  • Third Stage: Development of bony calluses.
  • Fourth Stage: Bone remodeling.
  • Fifth Stage: Bone support and recovery.
Jan 21, 2023

What slows down bone healing? ›

Limit Your Intake of Salt, Caffeine, Sweetened Beverages and Soda. Sodium, sugary drinks and colas can rob your bones of calcium, slowing bone mending. Caffeine also contains compounds that bind with calcium and prevent its absorption.

What foods help broken bones heal faster? ›

Your body needs plenty of protein to build new collagen for bone healing. Eat lots of protein-rich foods like lean meats, low-fat dairy products, beans, nuts, and fortified cereals. Leafy green vegetables like collard greens, spinach, broccoli, and kale are high in calcium, another important part of bone repair.

How do I know my fracture is healing? ›

Common Signs Your Broken Bone Is Healing
  1. *Routinely follow up with your healthcare provider during the healing process. ...
  2. Decreased Pain. ...
  3. Increased Range of Motion. ...
  4. Reduced Swelling. ...
  5. Less Bruising. ...
  6. *Routinely follow up with your healthcare provider during the healing process. ...
  7. Speak with an Orthopedic Specialist Today.

Is a foot fracture worse than a break? ›

Some people assume that fractured bones are more serious than broken bones, while others assume it's the other way around. But the truth is that these terms are used interchangeably, and they have the same meaning to medical professionals.

What is the least severe foot fracture? ›

The least severe break is a hairline fracture.

Also called a stress fracture, a hairline fracture is a small crack that doesn't go through the bone. Stress fractures are common in athletes and others who engage in repetitive jumping and running.

What is the most common bone injury in the foot? ›

The most common sites for stress fractures in the foot are the metatarsal bones.
  • Stress Fractures of the Metatarsal Bones. ...
  • Stress Fractures of the Fifth Metatarsal Base. ...
  • Stress Fractures of the Calcaneus (Heel Bone) ...
  • Stress Fractures of the Navicular. ...
  • Stress Fracture of the Talus. ...
  • Stress Fracture of the Sesamoids.

Should I sleep in the boot for metatarsal fracture? ›

Walker boot: Do not sleep in the boot. It is important to place as much weight as possible through the boot when walking to help the healing process. The boot should be worn when walking but can be taken off when you are: resting.

Can a 5th metatarsal fracture heal in 3 weeks? ›

The majority of acute, nondisplaced fractures of the fifth metatarsal heal with conservative treatment by 6 to 8 weeks.

Can I walk on a boot with a broken 5th metatarsal? ›

You are allowed to walk on your foot as long as it is not too painful. If you were given a boot, wear it while you are walking. You do not need to wear it when resting or sleeping.

Can I take my walking boot off when sitting? ›

It is ok to take the boot off at night, when resting at home and to wash. Regularly perform the exercises below to get your movement back.

When should you stop wearing a boot for a broken toe? ›

Depending on the symptoms, it's generally suggested that a patient with a toe fracture wears a rigid soled shoe or moon boot for approximately 3 weeks before transitioning into roomy, supportive and enclosed footwear, such as runners. Most patients return to activities of normal living after 6 weeks.

Can I wear a sock with my walking boot? ›

Adding a sock to the equation is a good idea for a few reasons: It will help reduce any friction between the brace and your skin, which can help prevent any chafing or blisters. Socks for walker boots can act as a buffer between your foot (and its sweat and dead skin cells) and the brace.

Can a Jones fracture heal in 4 weeks? ›

Most people need three to four months to recover from a Jones fracture. Complications like nonunion or refracture will extend your healing time. It'll also take your body longer to heal if you need bone grafting to repair your Jones fracture.

How serious is a Jones fracture of the foot? ›

The Jones fracture is recognised as the most serious of all the fractures which can affect the fifth metatarsal. Whether a doctor recommends a non-surgical treatment such as immobilisation, or a surgical procedure to treat a Jones fracture, can come down to a range of factors.

How bad is a Jones fracture? ›

While a Jones fracture is often slow to heal, in some cases, it may not heal at all. There is also a risk of reinjury. As such, a doctor may suggest repeat X-rays to monitor recovery and ensure appropriate healing. If the fracture does not appear to be healing, then a doctor may recommend surgery.

Does massaging a broken toe help? ›

Loosening the muscles and ligaments surrounding the site of the fracture can make a huge difference for the client. Increasing mobility– As a result of loosened ligaments and muscles, massaging the surrounding area of a fracture may be able to support with bringing back some much-needed mobility to the limb.

Does Epsom salt help broken toe? ›

You may have also heard various myths about broken toes. You know, myths like there's nothing a doctor can do to help your toe, if you can move it then it's not broken, and toe injuries should be soaked in hot water with Epsom salts right away. These are all harmful and untrue!

How do you stay active with a broken toe? ›

These can include using rowing and elliptical machines, in addition to swimming and bicycling. If the fracture is minor, buddy taping may be an effective method in providing the stability that is necessary as the healing process occurs.

What happens if you walk on a broken toe too soon? ›

If you return too soon you may worsen your injury. You may safely return to your normal activity when you can walk straight ahead without pain or limping.

Is a broken toe still swollen after 6 weeks? ›

A typical toe fracture will take about 6 weeks to heal. However, residual swelling and dysfunction can persist for even longer. It is not uncommon to still have residual symptoms following a significant toe injury even 3-4 months after the injury.

Can a broken toe get worse over time? ›

A fractured toe that's left untreated can lead to infection

You're at increased risk of developing a bone infection if you have diabetes, rheumatoid arthritis, or a compromised or weakened immune system. Symptoms that suggest your toe has developed a bone infection include: Fatigue. Fever.

Can a 5th metatarsal fracture heal in 2 weeks? ›

How long does a fractured 5th metatarsal take to heal? A 5th metatarsal fracture often heals in six to eight weeks, whether treated by immobilization or through surgery. Weight-bearing activities are significantly reduced for six weeks following surgery.

Can you use a walking boot with metatarsal fracture? ›

You should remain immobilized in a walking boot/post-op shoe until 4 weeks from the initial injury. You are allowed to fully weight bear as tolerated in the walking boot/post-op shoe.

Can a metatarsal fracture heal in 2 weeks? ›

A metatarsal fracture may take from 6 weeks to several months to heal. It is important to give your foot time to heal completely, so that you do not hurt it again.

How do you tell if toe is broken fractured or sprained? ›

How to Tell The Difference Between a Fractured and a Sprained Toe? The critical difference between a broken and sprained toe is in the mobility of the toe. A broken toe will have little to no movement while a sprained toe will still have some mobility, although it may be painful.

How does a fractured toe look like? ›

Bruising of the skin around the toe may also be noticeable. The toe may not look normal, and it may even look bent or deformed if the broken bone is out of place. It may be difficult to walk because of the pain, especially if the big toe is fractured. Shoes may be painful to wear or feel too tight.

What does a fractured toe feel like? ›

your toe is pointing out at an odd angle. the bone is sticking out of your toe. there was a snap, grinding or popping noise at the time of injury. you feel tingling in your toe or foot or it feels numb.

Can you wiggle a broken toe? ›

You might be able to wiggle a broken toe or even walk on it, but movement can actually make it worse.”

Can you wiggle your toes with a broken foot? ›

A severe fracture will limit motion due to swelling and pain, but a non-displaced single fracture of most bones of the foot and ankle will allow full motion of the extremity, and this is certainly the case in stress fractures.

Does it hurt to touch a fractured toe? ›

Symptoms of a stress fracture in the toe include: pain that occurs after activities such as walking or running. pain that goes away with rest. soreness or tenderness when touched.

How long will a fractured toe hurt? ›

It can take 4 to 6 weeks for complete healing. Most pain and swelling will go away within a few days to a week. If something was dropped on the toe, the area under the toenail can bruise.

What is the best way to treat a fractured toe? ›

Broken Toe Treatment
  1. Stay off the foot as much as possible.
  2. Avoid movement or pressure that causes pain.
  3. Apply ice up to 20 minutes at a time. ...
  4. Keep the foot elevated as often as possible, especially the first 2 days after injury, to help control pain and swelling.

Can you walk on a broken toe and not know it? ›

If you've ever injured your toe before, then you know the agonizing pain, swelling and immobility that can come along with the injury. But all too often, individuals don't realize their toe may in fact be broken. When broken toes go undiagnosed, mistaken for a sprain, further injury can occur.

What shoes to wear for broken toe? ›

To help facilitate the healing process for broken toes, a medical professional like a podiatrist might recommend that the patient wears what is called a stiff-soled shoe.

Can you stand on a broken toe? ›

If you've broken your toe, the skin near the injury may looked bruised or temporarily change color. You'll also have difficulty putting any weight on your toe. Walking, or even just standing, can be painful. A bad break can also dislocate the toe, which can cause it to rest at an unnatural angle.

Can you walk with a broken toe? ›

You'll have much less pain after four weeks and should be walking normally again after eight weeks, Dr. King says. At 12 weeks, your broken toe should be fully healed.

Should you ignore a broken toe? ›

Importance of Seeing a Doctor

However, ignoring a broken toe can lead to a chronic, painful condition called osteoarthritis, which causes pain in the joints. In addition to future problems from the broken toe itself, you may have sustained nerve damage, especially if you have tingling or numbness in your toe.


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