Painful Problems with the Toenails

The toenails in the feet can have a lot of different conditions that can affect them and be painful. They get subjected to a lot of pressure and load from shoes and daily activities. They all get knocked around a lot and get things dropped on them a lot. It is no wonder that there are so many problems that podiatrists see in their patients with problems of the toenails.

On ingrown toenail is probably the most well known painful problem of the foot. This occurs when a corner of the nail penetrates the skin and sets up an inflammation. This is most often due to a curved shape to the nail and a poor toenail cutting technique that leaves a sharp corner. A skilled podiatrist can easily remove that offending piece of nail and give almost instant relief for this. However, the problem does tend to recur, so a minor surgical procedure to remove the edge of the nail should be considered.

Probably one of the more common causes of pain around the toe nails is a condition that is technically known as onychophosis. This is where there is a lot of pressure down the sides of the nail which causes a callus to develop in the nail groove. This callus or onychophosis becomes so thick that it becomes painful. This is very commonly mistaken for an ingrown toenail. This type of problem needs the expert skills of a podiatrist to meticulously remove the callus from the nail groove and file the nail away from the painful area. Long term if the onychophosis is an ongoing problem a minor surgical procedure to remove the edge of the nail can be done.

Trauma to a nail plate such a repeated stubbing of the toe against the end of the shoe or the one off trauma of, for example, dropping a heavy object of the foot can result in a deformed nail plate that grows in a distorted way. The technical term for this is onychogryphosis. Once the nails starts to grow like this, it can not be fixed. The only way to deal with this is to regularly debride the nail, most likely by a podiatrist or to have the nail permanently removed by minor surgery.

Another common problem with the toenails is a fungal infection or onychomycosis which causes the nail to take on a whitish or yellowish colour that may crumble and become distorted. The actual amount of distortion of the nail and what colour it appears at will depend on the exact fungus that infects the nail. Unfortunately for our feet fungi love darkness and moisture and that is the exact environment that you have in the foot when it is in a shoe. This hostile environment makes the treatment challenging. Usually, the treatment involves regular reduction of the nail plate and the use of a topical agent to try and inhibit the growth of the fungus. Other options include lasers or oral agents. Treatment can last many months and a lot do tend to recur.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.