05 Jul Causes Of Toenail Pain
Toenails – it’s amazing how something so small can cause so much pain at times. While some causes of toenail pain may be minor and can be treated at home, others may need more urgent care in order to stop them from getting worse and really interfering with your everyday life. As with everything we do here at Masterton Foot Clinic, it’s always important to identify the root cause of toenail pain so that you’re not just temporarily treating the symptoms, but also addressing the cause to treat the problem for good – and even helping prevent it from returning in the future. Here are four of the top causes of toenail pain that our podiatrists see and treat in our clinic.
Toenail Trauma
Toenail trauma describes damage or injury to the toenails, and can occur due to various reasons ranging from dropping heavy objects on the foot, falling and stubbing a toe, to wearing ill-fitting shoes that constantly press on the ends of the toes, creating microtrauma. This means that repetitive exercises like running can also contribute to toenail trauma.
Symptoms of toenail trauma include a reddish-black bruise under the nail (called a subungual haematoma), pressure under the nail, visible separation between the nail and the skin, and general toenail pain. Minor bruising usually resolves on its own, but wearing comfortable shoes can aid in pain relief during the healing process.
If you’re experiencing notable toenail pain that doesn’t resolve within a few days of the incident where you hurt your toe, you should see your podiatrist. They can assess the toe to see if there’s anything else going on, like an infection, or if the trauma has led to part of the toenail becoming ingrown.
If you notice bruising or bleeding beneath the nail that is painless and you haven’t experienced any toenail trauma, then it’s advisable to consult your podiatrist too – or read up about the difference between bleeding beneath the nail and a subungual melanoma.
Fungal Nail Infection
Fungal infections can affect both the toenails (onychomycosis) and the skin of the toes and feet (tinea pedis or athlete’s foot). When your nails are infected with fungus, they can thicken and become discoloured. While simply having a fungal nail infection isn’t typically painful (although an Athlete’s foot infection can get itchy and uncomfortable), if your nails thicken significantly, it can lead to your shoes pushing down on the nails and causing pain and discomfort. The surrounding skin can become red and irritated too.
If you’re concerned about a fungal nail infection, we’re proud to have New Zealand’s leading antifungal nail treatment – the Lunula cold laser. It’s completely safe, effective and pain-free with no side effects – using cold laser to destroy the fungus and support your defence systems.
Ingrown Toenail
Ingrown toenails occur when a piece of your nail, typically a sharp nail spicule, grows into the surrounding skin. ‘Picking’ at or pulling your toenails, curving the toenails when you trim them, and wearing tight shoes can all increase the risk of developing ingrown toenails – as well as several other factors that you can read about here.
Ingrown toenails embody the meaning “small but mighty”, with a very small nail spicule having the potential to cause severe pain and discomfort and lead to patients coming in to see us limping in pain. Untreated ingrown toenails can also lead to complications like infections.
The good news is that ingrown toenails can be safely and effectively treated – and we have a range of options to do so. This may involve:
- Conservative care where we remove the troublesome nail edge that has penetrated the skin with minimal impact on the nail itself. It’s simple, quick and usually not done under anaesthetic so there may be a little bit of discomfort that is quickly followed by a lot of relief. While this is a great option to relieve pain for those with first-time ingrown toenails, this does not permanently correct the nail or stop it from coming back again – which is why it’s important to assess the cause and better understand if it’s a one-off occurrence, or the problem is likely to recur in the future.
- Surgical correction where we complete a minor nail surgery to both remove the bothersome nail edge and importantly, apply a chemical that’ll stop that particular edge growing back. If you tend to get worried about the term ‘surgery’ – there’s nothing to fear here. This small procedure is done within an hour at our clinic in your regular podiatry chair and all under local anaesthetic so you don’t feel a thing. You can view a timelapse of the procedure being completed at Masterton Foot Clinic here (warning: discretion is advised, this is the actual procedure with no censoring).
Paronychia
Paronychia is an infection, most often bacterial, that primarily affects the skin surrounding the nails. It can be due to the cold sore virus, herpes and yeast infections. Although it typically occurs in the fingernails, it can also affect the toenails. Factors such as trauma to the toenail or untreated ingrown toenails can increase the risk of developing paronychia. Symptoms include pain in the toenail, warmth and redness in the skin, swollen toes, pus, chills, fever, and nausea. Soaking the feet in warm water can help alleviate pain and swelling.
A big concern with paronychia is the risk that it will lead to cellulitis, which can present as pain, redness, and warmth spreading up the feet and legs from the affected area. Severe cellulitis may manifest as red streaks on the legs, fever, and nausea, requiring immediate medical care. Paronychia also often leads to nail dystrophy, changing the appearance of toenails to appear distorted, develop ridged nail plates, grow brittle or even change colour to a yellow, green or even black.
If you suspect you have paronychia, see your podiatrist or doctor for a formal diagnosis, as you may require antibiotics or other treatments depending on the cause. In the meantime, try to keep your feet clean and dry, and wear socks that wick moisture away from the feet.
Home Care Tips For Painful Toenails
If you’re experiencing painful toenails, we recommend:
- Warm Water Soaks: Soaking your feet in warm water can help reduce pain and swelling associated with various toenail conditions. Fill a basin or tub with warm water and soak your feet for 15-20 minutes, two to three times a day. Adding Epsom salt to the water can provide additional relief.
- Proper Nail Trimming: Trim your toenails straight across and avoid cutting them too short. This can help prevent ingrown toenails, which are a common cause of toenail pain. Use clean and sanitised nail clippers or scissors specifically designed for toenails.
- Comfortable Footwear: Wear comfortable shoes that provide adequate space for your toes. Tight or ill-fitting shoes can contribute to toenail pain. Opt for shoes with a wide toe box and good arch support. Avoid high heels and shoes that put pressure on the toes.
- Moisturise: Keep your feet and nails moisturised to prevent dryness and cracking. Apply a moisturising lotion or cream to your feet daily, paying attention to the nails and surrounding skin – though avoid any cream being trapped in the space between the toes.
- Over-the-Counter Pain Relief: Over-the-counter pain medications such as non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate mild to moderate toenail pain. Always follow the recommended dosage instructions and consult a pharmacist or healthcare professional if you have any underlying medical conditions or are taking other medications.
- Protect Your Toes: If your toenail has fallen off or is partially detached, protect the exposed area by keeping it clean and dry. Use a sterile bandage or dressing to cover the toe and prevent further injury or infection.
- Avoid Self-Treatment: It’s important to avoid attempting to treat nail conditions like forcefully removing ingrown toenails, at home. These procedures should be performed by a podiatrist to prevent complications and infections – they know exactly what to look for. More than that, they won’t just treat the problem, but help you with a plan to help prevent the issue from recurring in the future.