Common Causes of Toenail Pain

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When was the last time you paid much attention to your toenails? Sure, you keep them clean on a daily basis. And, of course, you trim them from time to time, or go further with pedicure service and other nail salon treatments. But in between those moments, you probably don’t think much about your toenails…unless they hurt or start to look a little strange.

At that point, it becomes impossible not to think about them, and to start worrying about the cause of your discomfort. Toenail pain is no laughing matter, and it can escalate to levels that force you to seek medical treatment if not dealt with in time. But what’s at the root of toenail pain?

Common Causes of Toenail Pain

  1. Ingrown toenail
    An ingrown nail is a painful condition that occurs when the edge of the toenail penetrates the soft flesh around the nail, causing swelling, redness, pain and sometimes infection at the location. It’s a common ailment, and can be triggered by a wide range of causes. Most often, we see it in individuals who wear shoes that crowd the toes. This can include shoes with a narrow toe box and high heel shoes, which naturally subject the forefoot and toes to increased pressure.

    Another common cause is trimming toenails too short, or curving at the edges. This can change the way the nail and nailed interact. When trimming toenails, always cut straight across.

    Trauma can also cause ingrown toenails. This can stem from dropping something on the toes, stubbing a toe, or even wearing shoes that allow too much movement and repeated impact of the toes. Repetitive trauma like this can cause nail to start growing abnormally inward.

    Under any of these circumstances, it’s best to seek treatment from a podiatrist, especially if it has gotten worse over time. Delaying treatment can lead to extreme pain and the risk of infection. This type of bacterial infection can eventually spread to the underlying bone, causing a bone infection that can permanently damage the toe(s).

  2. Fungal infection
    Fungi thrive in dark, moist and warm environments. That makes the toenails very susceptible to fungal infection, especially among people who wear shoes all day and are physically active. A toenail that is infected with fungi appears thick, discolored and/or crumbly. If left untreated, it can spread to other nails and the surrounding skin. The fungal infection itself may not cause pain, but you can experience pain when the toe rubs against the inside of your shoe during activities.

    Toenail fungus infections are notoriously difficult to treat, and it is rare for anyone to see improvement on their own. The best treatment option currently available is laser nail fungus therapy. A laser treatment session is very effective in killing most or all of the fungus. However, there is always a risk of reinfection from your daily activities (exercise, public pools and showers) or even old shoes, socks, blankets, carpet, etc. Because of this, we recommend a multi-treatment plan over a single treatment session. This will help you to actively fight off new infections and make faster progress in achieving clear nails

  3. Blue toe syndrome
    This is a condition where there is a blockage in the small blood vessels of the foot. This action reduces the supply of blood and oxygen to the area. The toe can turn blue and become very painful. Blue toe syndrome may be confused with chilblains or other disorders until properly diagnosed.
  4. Subungal corn
    This is a condition where a corn develops and grows upwards under the toenail. This causes pressure as the corn’s growth is trapped by the nail, which starts restricting the growth. You may need to have the nail lifted or partially removed to alleviate symptoms.
  5. Other factors
    Toenail pain can be caused by other factors such as melanoma, psoriasis, cysts or tumors (such as osteochondromas) found under the nail. You may also experience discomfort if you have any type of deformity of the foot, such as bunions or hammertoe, as these conditions change the structure of your foot.

Whether your toenail is in pain because of direct trauma or as a result of any of the other conditions described above, monitor it and see a foot doctor if it doesn’t clear up with a few days. We’ve all stubbed a toe and immediately asked ourselves “Is my toe broken?”, only to see the pain diminish overnight. However, chronic pain, especially when associated with visible symptoms, should be addressed by a medical professional. Call (713) 541-3199 to schedule ab appointment with Dr. Gabriel Maislos, DPM, FACFAS at Houston Foot and AnkleCare today.


Houston Foot and Ankle