Ouch – why are my toenails causing me pain?

Why ingrown toenails develop – and how to prevent them

Pain and tenderness in the big toenail is not an uncommon complaint but common or not, the discomfort can be so great it can stop you from doing the activities you normally do or wearing the shoes you want to wear. If your toenail is tender and sore it is most likely because the toenail is ingrown.  An ingrown toenail (or onychocryptosis) is a toenail that has grown into the skin or occurs when a fold of skin on the side of the toenail has grown over the nail. The condition commonly occurs in big toenails but any of the other toenails can also be affected. Left untreated it can become swollen and red and infected, causing a great deal of pain.

Why does my toe nail hurtCauses of ingrown toenails

A variety of factors and influences can result in ingrown toenails.

  • Some types of physical activity may cause repeated pressure on your toes and this may also result in an ingrown toenail developing.
  • Additionally an ingrown toenail can occur from a trauma to the toe, such as stubbing the toe or having the toe stepped on or dropping a heavy object on it.
  • The other major cause of ingrown toenails is the consistent wearing of shoes that are too tight. It is pertinent that in populations that do not wear shoes, there are no reports of ingrown toenail cases, which makes us assume a link between footwear and ingrown toenails. It is important to make sure that the shoes you wear on a regular basis do not constrict your toes, especially shoes in which you do physical activity. That means the shoes you wear all day at work, particularly if you are walking to and from transport, as well as sports or performance shoes.
  • And while we all need to regularly cut our toenails, we have to be careful to not cut our nails too short. Sometimes if you cut your toenails too short it can result in an ingrown toenail developing. Excessive trimming of your nails can encourage your nail to grow into the skin and a fold of skin to form over the nail bed. To reduce the risk of this occurring, you should regularly and properly trim your toenails.
  • And, unfortunately, some people are always going to develop ingrown toenails because their genetics result in their toenails growing too large for their toes.

Prevention of ingrown toenails

The best and most proven way to avoid ingrown toenails is to take good care of your feet. For example:

  • Have your toenails regularly and correctly trimmed by a trained podiatrist.
  • Wear properly assessed and fitted footwear, for your everyday as well as physical activities.
  • Wearing shoes when doing jobs around the house, like gardening or moving furniture, will help protect your toenails should you fall or drop a heavy object on them.
  • When kids are playing outside, riding bikes or skateboarding, for example, wearing proper shoes ensures their feet are adequately protected from childhood thumps and bumps.

Treatment

Ingrown toenails can be treated either with a simple procedure where the nail spike is removed from the affected toenail or, in more severe cases, surgery under local anaesthetic to remove part or all, of the nail.

However, treat your feet with the care they deserve and you can help avoid ingrown toenails altogether.

Read more  Everything You Should Know Before You Get Nail Tips


— Update: 07-01-2023 — cohaitungchi.com found an additional article 6 Reasons Your Toenail Hurts When Pressed from the website www.verywellhealth.com for the keyword why does my toe nail hurt.

If you stub your toe or drop something heavy on your foot, you may develop a subungual hematoma, which is blood and fluid trapped beneath the toenail. This gives the toenail a red, black, or purple discoloration. It is often called black toenail for that reason.

A subungual hematoma is usually caused by trauma from a heavy object, but a single incident isn't always the cause. It can also develop from frequent rubbing against a shoe. For example, people who do a lot of walking or running, such as marathon runners or hikers, are more prone to them.

This article will explore symptoms of subungual hematoma and when you should seek medical treatment.

Verywell / Jessica Olah

Symptoms of Bleeding Beneath the Nail

A subungual hematoma can range from a small spot under the nail to a large area of discoloration. It can happen to toenails or fingernails.

The nail may hurt or feel tender when touched.

Depending on the amount of blood beneath the nail, the nail may come loose and fall off. But often the nail does stay intact, and the blood fades as the nail grows out.

When to See a Doctor

If a subungual hematoma is large and causing pain, medical treatment may be needed to drain the blood and relieve pressure under the nail.

If left untreated, the condition could damage the nail matrix, the area from which the nail grows, causing it to grow incorrectly or not at all.

If the nail is raised or cut, it could also increase the risk of a fungal or bacterial infection.

If you have bleeding under the nail or damage to the nail, it's a good idea to have you toe looked at by a medical professional within 48 hours. That way, the blood can be drained if needed.

Delayed treatment could increase your risk of permanent changes in the nail.

It is especially important to see a doctor for the following:

  • You had blunt trauma to the toenail, such as a heavy object dropped on the toe, which may also include a broken toe bone that needs treatment or a cut that needs stitches.
  • There is severe swelling, pain, or redness of the toe.
  • Discharge is draining out from under the toenail.
  • The toenail becomes loose.
  • You have neuropathy, diabetes, peripheral artery disease, or any condition that affects healing or circulation.
  • The discoloration appears as a linear streak or a stripe along the length of the nail. Although a streak of pigment is often normal, in some cases it may be a sign of the skin cancer melanoma.

If the nail is raised, the doctor may relieve the pressure by drilling a hole through the nail. If it is loose, the nail may be trimmed or even reattached to protect the nail bed while the nail is regrowing.

You should avoid removing or drilling the injured nail yourself at home. Doing so could lead to infection and slow the healing process. If you are unable to see a doctor right away, bandage the nail and avoid trimming or cutting it.

Changes in Nail Structure

Nail damage may also lead to changes in the nail's structure. These changes may occur after an injury from a heavy object, chronic rubbing against the shoe, or in response to irritation from infections.

Some of the most common changes in nail structure are:

  • Nail thickening: This is caused by damage to the nail's growth center. It responds by producing a thicker nail.
  • Nail loosens or falls off: Sometimes the entire nail or a portion of it will loosen or fall off. This is called nail avulsion. It's often a temporary condition, and the nail will regrow over the course of a couple of months.
  • Permanent nail changes: You may see permanent splitting or a decrease in size. If there is severe damage to the area where the nail starts to grow, it may not regrow.

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Summary

Bleeding beneath the nail can happen after an injury, such as a heavy object landing on the toe, or from chronic rubbing within your shoes.

If it covers a large area of the toe or is painful, medical treatment may be needed to relieve pressure and help prevent permanent nail changes.

Sometimes bleeding under the nail can change the structure of the toenail for a period of time and may lead to the nail loosening or falling off. This is usually temporary, but if the trauma was severe it may be permanent.


— Update: 07-01-2023 — cohaitungchi.com found an additional article What’s Causing The Pain In Your Toenail? from the website bucksfootclinic.com for the keyword why does my toe nail hurt.

Here are a few possible reasons for the pain in your toenail:

  1. Paronychia

Paronychia is an infection that affects the skin around your nails. Though it usually affects your fingernails, it can also affect your toenails.

You are at an increased risk of developing paronychia if you suffer from trauma to your toenail or have an untreated ingrown toenail. These issues make it very easy for bacteria to enter your system and give you an infection.

Often a simple foot soak can help ease pain and swelling. If even after frequent foot soaks your symptoms worsen, if you see pus or infection, or if you suffer from any immune system issues like diabetes, you would have to see your physician and get the infection drained.

With paronychia, you have to be on the lookout for any signs of cellulites. These signs could include pain, redness, and warmth of the cellulite-laden skin. These symptoms could present a serious bacterial infection, communicable to the surrounding tissue. If these symptoms do occur, see your physician immediately and be prepared for antibiotics.

With the increased severity of cellulites, you might see red streaks on your legs, fever, and nausea. If this does happen, you should get immediate medical care.

Symptoms:

  • Pain in toenail
  • Warmth in skin and redness
  • Swollen toe
  • Pus
  • Chills
  • Fever
  • Nausea
  1. Toenail Trauma

Toenail trauma can occur when you drop something heavy on your foot, fall, stub your toe, or even wear shoes that don’t fit you right. You could also experience toenail trauma from exercising.

You’ll experience minor bruising, but it’ll go away on its own. Make sure you wear comfortable shoes to allow your feet to heal and ease the pain.

If your pain is severe, however, visit a podiatrist. They’ll be able to drain the blood out from under the affected nail. Never do this at home, because it could lead to a severe infection.

In some instances of toenail trauma, your toenail may just fall off entirely. The nail will regrow within the next few months. In case this occurs, make sure you keep your toe dry and clean at all times. Wear shoes to protect the sensitive area that is normally covered by the nail. Avoid shoes that put pressure on your toes.

You can take over the counter pain relievers to deal with the pain. Make sure to keep your foot elevated, because this helps decrease the swelling in your feet and toes.

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If you still suffer from pain and there’s discolouration, or if you notice a dark area of “growth” under the infected nail, see a doctor immediately to rule out tumors.

Symptoms:

  • Reddish-black bruise under your nail
  • Pressure under your nail
  • Pain in toenail
  • Visible and distinct separation from skin and nail
  1. Hangnail

Though they are called “Hangnails”, they are not actually nails. Hangnails are actually small bits of skin that peel off the corner of your nail. They’re very common and can lead to pain in your toenail. They’re more common on fingernails but can also affect your toes. Some common causes are:

  • Soaps that irritate your skin
  • Cold climate
  • Nail-biting (for fingers)
  • Dry skin

It’s important to remember that you should never rip off a hangnail, as it can lead to infection. Hangnails may also bleed in some cases.

  1. Fungal Infection:

Fungal infections can affect your toenails or the skin on your feet and toes. When they affect your toenails, it’s called Onychomycosis. When it affects your skin, it could be athlete’s foot.

Onychomycosis can discolour and thicken your toenail. You may also experience pain, specifically when pressure is applied to your nail while wearing shoes.

You can usually treat this condition with medicated nail polish, which is available at most pharmacies near you. If you notice your symptoms get worse or do not go away, visit a podiatrist and they’ll be able to find the right antifungal medicine for you!

Symptoms:

  • Discolouration and thickening of the nail
  • Pain in toenail
  • Nail splitting
  • Itchy or painful feet or toes
  • Skin peeling between your toes
  • Redness
  1. Pain in Toenail When Pressed? It Could Be An Ingrown Toenail!

The most common cause behind pain in toenail when pressed is Ingrown Toenails. An ingrown toenail happens when the skin that surrounds your nail grows over the tip. When you cut your toenails shorter than you need to, or if you wear shoes that are too tight, you make yourself susceptible to ingrown toenails. When untreated, an ingrown toenail can be very uncomfortable and can also lead to infections like paronychia.

If your ingrown toenail is not significantly bad and doesn’t show signs of infection (like drainage and warmth), it can be treated at home. Soak your feet in warm water multiple times a day, this will help you with the tenderness and redness.

To give yourself relief when you have an ingrown toenail, take over the counter medicines for the pain and make sure to wear shoes that fit you well, i.e. don’t pinch your toes. This will allow your nail to heal as well.

If at-home treatments don’t help you, visit a podiatrist. They’ll be able to trim or partially remove the affected nail. If you notice your simple ingrown nail is worsening, visit a podiatrist immediately. You’ll know it’s worse if you notice pus, an unpleasant smell, and discharge.

If you have a condition like diabetes, visit a doctor or podiatrist as soon as you notice an infected ingrown toenail. You’re at high risk of developing a severe infection.

Symptoms:

  • Pain in toenail and skin surrounding it
  • Redness around nail
  • Fluid-filled bump on edge of your nail bed

Conclusion

Now that you know some of the common reasons people get pain in their toenails, you’ll be able to identify and treat the pain in your toenail properly. Book an appointment with Bucks Foot Clinic for the best podiatric treatment in town.

References

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About the Author: Tung Chi