My pinky toe hurts really bad. I think I broke or sprained it. Even If I get it X-rayed would there be anything they could do to heal/fix it?

Wrap. If a simple break, we would tape it together.
Yes. They would still be able to operate if necessary. You can buddy tape it to your 4th toe next to it. They can also prescribe pain medications. Please have it looked at if it is so painful.