Most people have experienced the painful, infuriating misfortune of stubbing a toe. But why does this seemingly minor injury hurt so darn bad in the moment?
It’s a question that actor Kevin Hart (a fellow toe-stubbing victim) recently posed to Twitter: “I swear stumping your pinky toe might be some of the worst pain on the planet,” Hart wrote. “I just don't understand how it hurts so bad and then goes away so fast...how???? Help me understand this shit please...I almost cried just now...And then it was over.”
Although it may seem like a lesser injury, when you stub your toe, there is actually a good deal of force behind the movement due to the weight of your body and your momentum converging on that tiny body part.
“In fact, you can put two to three times your body weight on that small surface area if you’re jogging or walking fast,” Georgeanne Botek, D.P.M., who works in the Department of Orthopaedic Surgery at Cleveland Clinic, tells SELF.
Toes contain a whole bunch of nerve receptors that get struck by the blunt force on impact.
“Each digit has two nerves, one on either side,” Dr. Botek says. “So no matter where you hit your toe or how you stub it, it’s going to affect a nerve impulse from your toe to your brain.”
This nerve impulse is modulated by sensory neurons called nociceptors, which fire off information to the brain whenever they sense an external stimulus that may cause harm to the body. That includes extreme heat or cold, certain chemicals that could burn the skin, or mechanical pressure that could damage the tissue (like the force involved when you bang a toe into the hard foot of a chair, for instance).
“When that specialized neuron gets activated, it fires, sending that information to the spinal cord,” Jeffrey Mogil, Ph.D., a neuroscientist and professor of pain studies at McGill University, tells SELF. From there, the information is processed by the brain and, eventually, you perceive it as pain.
There are two separate waves of perceived pain: the immediate, sharp “ouch” followed by a lingering, achy sensation.
The nociceptors, which communicate via thick, insulated nerve fibers, transmit the sensory information to your brain “essentially instantaneously,” Mogil explains. This is the first pain response you’ll feel—a sharp, intense discomfort that might make you yelp a four-letter word.
Then there are thin, uninsulated nerve fibers that fire more slowly and produce what’s called second pain, which is a duller burning sensation that lasts a bit longer. “The lag between first pain and second pain can be half a second or a second,” Mogil says. Additionally, your pain reaction may be associated with an emotional response, like frustration or anger.
While it can be unpleasant, this pain response is actually a reminder that your nervous system is working properly to help protect you from harm. In general, pain functions as an alert system telling you to stop whatever it is you’re doing that could potentially cause tissue damage, like grabbing a hot pan with your hand. But it’s not particularly useful when you stub your toe, Mogil explains, “because in that case, by the time you feel it, the damage is already done, and it’s too late to avoid it.”
The anatomy of your toes also makes them particularly vulnerable to injury.
”When you’re stubbing your toe, you’re hitting not only those nerves, but also the skin, the nail, and the bone,” Dr. Botek says.
In most cases, your pain will go away after a few seconds or minutes. But if not, that’s a sign that something more serious has happened. For example, your toenail “can act like a piece of glass on your skin and cause damage to the skin itself,” she says. In other cases, the nail bed might get bruised, causing bleeding under the toenail.
Also, the bones in the toe are relatively unprotected. “You don’t have a lot of fat pads on your toes, like on your abdominals or buttocks, so it’s a very fine diameter between the tip of your toe and the bone,” Dr. Botek explains. Because the bone is not well-cushioned, you can get a bone bruise, she adds, which can cause serious pain that lasts for several weeks or months without any visible injury on the outside.
And, of course, you can also break your toe if you stub it hard enough. In that case, you might notice extremely intense pain, black and blue discoloration, swelling, and misalignment. “If the pain is a persistent 10 out of 10 for more than a few hours, then you should get it looked at,” Dr. Botek says.
But, a lot of the time, a stubbed toe is just that. It hurts like hell, but just for a little while.