It can be difficult to tell the difference between a broken toe and a sprained toe. Sometimes you will hear the bone break, or you will see that the toe has been knocked out of its socket (i.e., dislocated). These signs and symptoms usually point to a traumatic toe fracture and not a sprain. But stress fractures, which are not usually caused by a single traumatic event, can be harder to distinguish.
Both strains and stress fractures result in swelling and pain in the injured area. Both are often not diagnosed by a doctor because the pain comes and goes, and the injured person is able to walk and continue with his usual daily activity. However, this mobility can be misleading. Untreated sprains or stress fractures on the toes can lead to chronic foot pain, deformity and arthritis as well as ankle, knee and hip pain. For example, the Jones fracture (a special type of fracture that occurs at the base of the fifth metatarsal, or the little toe) is often misdiagnosed as a sprained ankle. But treating a Jones fracture as a sprained ankle can lead to serious complications in the future.
In order to properly distinguish a sprained toe from a fractured toe, it is necessary to visit your doctor. Stress fractures often require x-rays to arrive at a confident diagnosis (this kind of “hairline” fracture shows up as a faint line on the metatarsal bone in the x-ray). Another distinguishing factor is the localization of the pain. Both traumatic and stress fractures most often result in what doctors refer to as “pinpoint” pain. That is the pain occurs exactly at the point of the fracture. Sprains, on the other hand, result in more general pain and swelling in the affected region.
Toe fractures and sprains are often treated by icing the injury, wearing comfortable shoes that protect the toes and, most importantly, resting the foot. Fractures (particularly traumatic fractures) are often also treated by splinting the toe in order to keep it immobile. Sometimes the injured toe is taped to toe next door also in an effort to stabilize the injured toe. This treatment is referred to as “buddy taping.” A stiff-soled shoe also can be used as a sort of splinting device. In more serious cases, surgery may be necessary. All of these treatments are, of course, subject matter to be discussed with your general practitioner or podiatrist.