The side of the nail hurts, but its not ingrown

Pain down the side of a toenail is relatively common, but a true ingrown toenail is not that common. By definition an ingrown toenail has grown into the skin. That means the edge, or a sharp corner of the nail has actually penetrated the skin and made a hole in the skin. This can be quite painful and a portal for an infection to get in. That is what a true ingrown toenail is. What is more common than that is when the side of the nail hurts but it is not ingrown, ie the nail has not penetrated the skin. What is happening here is that the edge of the nail is pushing on the skin and it becomes painful from that pressure, but the nail does not actually penetrate the skin. Often times a callus may build up between the nail and the skin in the nail groove and this becomes even more painful. This callus down the side of the nail groove is called onychophosis and can be quite painful.

The cause of this pain down the side of the nail is almost always due to the shape of the nail. In most cases the nail is curved over at the sides and pushed down on the nail groove. This nail is generally shaped that way as that is the inherent shape of the nail. Some people’s toenails are just more curved than others. Pressure from the wearing of tight-fitting footwear can also force the edges of the nail to be more curved. The footwear also puts pressure on the sides of the toes and forces the skin in the nail groove into the curved nail and produces the pain and the formation of the callus of the onychophosis. If the nail has been cut poorly or a sharp corner is left on the edge of the nail after it has been cut, then these is a good chance that that sharp edge will penetrate the skin, resulting in a true ingrown nail rather than just pressure between the skin and the nail causing the pain.

The treatment options for this is to deal with what is causing the pain. If there is pain down the edge of the nail and its not ingrown, then the toe nail needs to be carefully cut and a file used to remove the callus or thick skin of the onychophosis removed. A podiatrists is the best person to do that. It is a skill that is built up over years of experience. After the callus has been carefully removed, then cotton wool or other material can be packed down the side to keep the nail away from the skin. If it is a true ingrown nail is the cause then that too needs to be carefully and expertly removed. If an infection is present, then antibiotics may be needed. In both cases of an onychophosis and true ingrown toenail, if they are an ongoing problem then it may be advisable to have some minor surgery to remove the offending piece of nail permanently.

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