Broken vs. Sprained Toe: How to Tell the Difference

Mar 29, 2022

Toe injuries are extremely common, regardless of age, gender, or any other status. Athletes may stumble and hurt a toe. Parents in the middle of multi-tasking may walk into a wall and stub their toe. Broken and sprained toes are frequently caused by car accident injuries. Whatever the reason, toe pain is no fun – and it can be hard to determine the seriousness of the injury.

Toe Pain Causes

The human foot consists of 26 bones and over 30 ligaments. Ligaments are the connective tissues surrounding the bones in your toes. Their job is to connect the bones of your toes to your joints. A sprained toe is caused by damage to the ligaments surrounding your joints. Damage to the ligaments makes it difficult for your joints to move freely without pain.

A broken toe is caused by fractures in any of the toe bones, also known as phalanges. Your phalanges are connected to your metatarsal bones. Because the phalanges are so small, it can be difficult to detect a fracture.

Kinds of Broken Toes

Fractures are categorized depending on the way the toe breaks.

  • Stress fracture: This kind of break is caused by repetition, overuse, or undue stress.
  • Non-displaced: When the bone breaks or cracks but does not separate, it is a non-displaced fracture.
  • Displaced: The bone breaks or cracks, and the ends separate from one another, either completely or partially.
  • Open: The broken bone protrudes and breaks the skin.
  • Closed: The broken bone is contained within the skin.
  • Avulsion fracture: A chip in the bone, usually caused by irritation from the tendon being pulled off the bone.

Broken Toe vs. Sprained Toe Symptoms

The initial pain of a toe injury, regardless of its nature, is a pretty shocking experience. This is part of what confuses so many when attempting to self-diagnose. A painful sprain may feel so intense that you wonder whether you broke it. However, there are a few telltale ways to determine whether your injury is a sprain or a break.

Sprain Symptoms

A sprain happens along any of the joints in the foot. In the smaller toes, there are three joints each, while the big toe has two joints. A sprain may be signaled by pain in the toe (especially when walking), difficulty moving the toe, swelling, bruising, and tenderness.

There are three categories, or grades, that medical experts place sprains into.

  • Grade 1: a fairly minor injury; You will notice some tenderness and swelling in the affected area.
  • Grade 2: a more moderate injury; characterized by more severe swelling as well as bruising and less range of motion in the affected toe.
  • Grade 3: the highest level; characterized by a complete tear of the ligament. A grade 3 toe injury is very painful and will cause significant swelling and bruising. It may be very difficult to move your toe.

Break Symptoms

Depending on the grade of the sprain, it can be very difficult to differentiate between a sprain and a break. A break will also cause swelling, bruising, and tenderness, and you may or may not be able to put weight on your toe with both a break and a sprain. Walking, standing, and other uses of your toe will be difficult with both injuries.

A sprain is likely to heal faster. You may notice the pain beginning to dissipate within a few days. The pain from a broken toe has more longevity.

Some other things to look out for to determine whether you are dealing with a broken toe include:

  • A sound like a snap or pop at the time of the incident
  • Pain that could be described as throbbing
  • Pain only where the fracture is; a sprain is felt more generally
  • Severe discoloration in one specific area of the toe
  • A clearly dislocated toe, or a toe that looks “wrong”

Broken Toe vs. Sprained Toe Diagnosis

Unfortunately, even with the minor differences you may be able to notice, the only foolproof way to diagnose whether you have a sprained or broken toe is to consult your doctor. Medical professionals have tools that make it easier for them to reach a definitive conclusion.

If you visit your doctor for such a diagnosis, they will likely ask you about the event that caused the injury and any details you may remember. They will ask what symptoms you have been experiencing as well as the extent of your pain. If they suspect a fracture, you will be referred to imaging. Imaging is any medical process that allows doctors to see inside your body. The most common such process with fractures is the x-Ray. In order to see exactly what has happened to your bones, the doctor will most likely take x-rays from several angles.

While sprains tend to go away on their own without much intervention, it is important to seek medical attention if you notice that the bruising, swelling, or pain is not going away or if you begin to feel numbness or tingling. This last symptom could be a sign of nerve damage and may require surgery to address.

Treatment for Broken and Sprained Toes

In most cases, there is little that can be done either at home or by a doctor in the event of a sprained or broken toe. Rest and immobilization to the best of your ability should be your main goals. You can manage pain using over-the-counter medications, like NSAIDs such as ibuprofen, naproxen, or aspirin. (Always be careful when using these medications; there is a risk of liver damage from overuse.)

One of the most common ways to manage immobilization of the affected toe is called “buddy taping.” This is achieved by using medical tape to secure the broken toe to its uninjured neighbor. This will allow the broken toe to heal more effectively while using the unbroken toe as a splint. Another form of immobilization is a walking cast or boot. These tools provide a significant amount of padding and allow you to walk with less pain by providing more shock absorption.

Sometimes, surgery is required for more serious fractures. Your doctor may use hardware like a screw to help hold the bones together. Medical hardware such as this is permanent.