Many people experience pain near the nail edge and assume it is an ingrown toenail. However, that’s not always the case.
In reality, the discomfort could be caused by any of the following causes. Learn how to determine the true cause of your nail pain and seek the right treatment.
1. Nail Fungus
The toenails protect the feet and help them work properly, but sometimes they get injured or damaged. Having the right toenail care routine helps prevent injuries and reduce discomfort. In some cases, a toenail may hurt when it is not ingrown and can be caused by fungus, pressure, or skin irritation. Fungus is one of the main reasons a toenail hurts but is not ingrown, because it can affect the nail itself and the surrounding tissue. Infections with fungus can cause the nails to change color and become thick and brittle. Fungus can also lead to a foul odor in the nail and surrounding area.
A fungal infection is a very common problem that can be difficult to treat at home. The best way to prevent a nail fungus is to practice proper foot hygiene and to inspect your feet regularly. Fungus thrives in warm and moist environments, so keeping your feet clean and dry is key to preventing an infection. You can also wear shoes that fit well and avoid putting unnecessary pressure on your toenails.
Another sign of a fungal nail infection is if your nails are brittle or if they break easily. This can be a result of an injury, but it is also a sign that you have an active fungus running rampant in your nail bed. If your toenails have a bad odor, it is likely a sign of a fungal infection as well.
Nail fungus can be treated with over-the-counter antifungal nail polishes that contain chemicals like amorolfine or ciclopirox. These antifungal nail polishes need to be applied frequently, and they can take up to a year before you see results. If these over-the-counter treatments don’t work, you should see a podiatrist for additional treatment options.
A podiatrist can assess the toenail and determine if it is a fungal infection or another condition that causes pain. They can also thin a thick nail, and they can prescribe medications to fight the infection. Failing to seek prompt care for this issue can lead to long-term pain and nail deformities.
2. Nerve Irritation
If the nail is throbbing and painful to the touch but there’s no obvious pressure, infection or injury, it may be an indication of nerve irritation. This is common, especially in individuals who wear tight or restrictive footwear that causes continuous contact with the toenails. The pain is also often triggered by walking or running, where the toenails rub against the sole of the shoe and exert pressure on the nail sulcus. Recognising the symptoms and adjusting your footwear and toenail trimming routine can help to alleviate this pain.
This is particularly common in individuals who wear shoes with narrow toe boxes and high heels, which cause the toenails to rub against the inside of the shoe, causing them to swell. Over time, this rubbing can cause the toenails to become thicker and more brittle and can irritate the toenail matrix, leading to pain when touched or pressed. It’s important to seek prompt treatment for this condition, to prevent the sensitivity from worsening.
Nerve irritation can also be triggered by toenail trauma, such as stubbing your toe or dropping a heavy object on it. This can lead to a painful throbbing sensation that feels like part of the toenail is penetrating through the nail plate when pressed. This is known as allodynia and is a very uncomfortable experience, with patients reporting it as stinging, throbbing and highly sensitive to touch.
It’s also important to seek prompt care for any significant changes in your toenails, such as yellowing or thickening. This could indicate fungal infections or signs of bruising or subungual melanoma beneath the nail, which can quickly progress and become more severe if not treated.
3. Nail Trimming
Nails that are trimmed too short or unevenly may develop sharp corners or cause the skin to curve under the nails, resulting in painful irritation when they’re pressed. Trimming the nails regularly and following proper nail prep techniques will help prevent this type of pain.
Changes in the colour or texture of your toenails should not be ignored, as they might indicate a serious health issue like an infection or injury. Yellowing or thickening can be a sign of fungus, while darker discolouration could be caused by bruising or melanoma. Any significant changes in the appearance of your toenails should be evaluated by a podiatrist, so that you can receive the right treatment and avoid complications in the future.
The nail sulcus (the groove along the side of the toenail) can become infected and form a callus, leading to sensitivity and pain when pressure is applied to the nail. This condition, called paronychia, is another common cause of pain near the toes, and can be either acute or chronic in nature. Acute paronychia often appears suddenly and is the result of bacteria entering through a small cut or injury, such as trimming too short or bumping the toe against something.
Chronic paronychia, on the other hand, typically develops more slowly over weeks or months, usually due to repeated friction and pressure, such as wearing tight shoes. This type of nail pain is often mistaken for ingrown toenails, since it causes similar symptoms, such as swelling, redness and an inflamed area where the nail meets the skin.
To reduce the risk of forming ingrown toenails, it’s important to trim your nails regularly using proper nail clipping technique. When cutting your nails, make sure they are straight across and not too close to the skin around them, and gently round off the corners using a nail file or emery board to keep them from catching on things. Keeping your toenails healthy also requires regular washing, to ensure dirt and debris doesn’t build up under the nails. Washing your feet daily and using a foot scrubber or pumice stone to remove any dead skin that builds up under the nails will help maintain their strength and health.
4. Calluses
Calluses are areas of thickened skin that form as a result of friction or pressure. They are typically yellowish in color and may feel rough or bumpy to the touch. They occur on the feet and palms of the hands, most commonly over areas of the body that take on the most pressure when walking or standing. Calluses are usually a protective reaction of the skin that helps prevent blisters from forming. However, if the friction is too much or it occurs over a bony area of the foot such as a hammer toe or bunion, then the callus can become painful.
Callus pain is often a result of wearing shoes that are too small or that rub against the feet over time. It can also be a result of wearing shoes that are too hard or too soft. Some patients are predisposed to developing calluses because of dry skin or other health factors. The use of corn and callus removers can help reduce the amount of pressure or friction that leads to pain.
If home care is insufficient to alleviate the pain, then it’s important to see a podiatrist for further evaluation and treatment. The podiatrist will examine the affected toe and skin and determine whether it is caused by an ingrown toenail, a fungal infection or another issue that needs professional attention.
The podiatrist will recommend a treatment plan based on the root cause of the discomfort. This may include using an over-the-counter callus removal product, soaking the foot in warm water or incorporating regular filing of the toenails into your foot care routine. The podiatrist may also recommend padding to protect the area. Padding can be purchased in the form of donut-style adhesive pads or you can make your own padding from moleskin.