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How do I Treat Toenail Pain?

By Bethany Keene
Updated Mar 03, 2024
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The common causes of toenail pain are badly-fitting footwear, ingrown toenails, fungal infections, and injuries. All of these problems can often be treated at home with measures such as over-the-counter medication and correct footwear. In some cases, however, it might be necessary to visit a healthcare worker for professional advice and treatment.

Footwear-Related Problems

One of the easiest toenail problems to treat is pain caused by improperly-fitting footwear. The shoes you wear can cause pain if the toe box is too narrow to allow your feet enough room. Any of the toes can be affected, but the big toe tends to take the most pressure from shoes that are too tight.

High-heeled shoes often cause this kind of pain because the shape of the shoes typically includes a narrow toe. The height of the heel is another factor, and in general, the higher the heel, the more likely the shoe is to cause some kind of pain. Wearing comfortable, low-heeled shoes instead of higher heels is the best way to reduce toenail pain caused by footwear.

If the cause of this type of pain is not addressed, the problem can worsen considerably, and ingrown toenails are a common consequence. In the long term, tight shoes can push the big toe out of alignment, forcing the joint to jut out from the side of the foot and swell, producing what is called a bunion. Bunions can be extremely painful, and severe ones may require surgery to treat effectively.

Ingrown Toenail

An ingrown toenail typically develops if the nail on the big toe is clipped with a rounded edge. As the nail grows, it becomes embedded in the skin along the side of the toenail. Wearing high-heeled footwear can also put pressure on the nail and cause this problem.

To treat an ingrown nail, soak your foot in a bath of warm water and Epsom salts to soften the skin. After approximately 15 minutes of soaking, dry the toe then gently push the skin away from the nail until it separates from the skin. Apply a small amount of antiseptic ointment to prevent the area from becoming infected. The soaking should be repeated as necessary, until the nail is long enough that it is no longer growing into the skin. To prevent the problem recurring, it can help to cut your toenails straight across, rather than with a rounded edge, and to wear properly fitting shoes.

It is important to catch ingrown toenails early, before they become too deeply embedded. If they are ignored for too long, it won't be possible to treat the problem at home using this method. In such cases, minor surgery involving a local anesthetic is required. In this procedure, a healthcare professional will remove the ingrown piece of toenail or, if needed, the entire nail.

Foot and Nail Fungus

Toenail pain can sometimes be caused by a fungus such as Tinea pedis, which causes athlete’s foot. Common symptoms include thick, crumbling toenails, pain, and fungal growth between the toes. A mild case of athlete’s foot can be treated by soaking the affected foot in a mixture of 25% vinegar in water. This treatment should be used daily until the fungus is gone, and the feet should be kept dry as much as possible otherwise.

If this doesn’t get rid of the fungus, over-the-counter oral medications or skin ointments are typically effective. In severe cases, you might need a prescription-strength medication. Sometimes, a medical professional might prescribe additional antibiotics or other medications for any accompanying problems.

Injury to the Foot

Nail pain caused by an injury, such as a stubbed toe or something dropped on the foot, is usually no cause for alarm. Keep an eye on the injury for a few days to be sure it is not serious, and treat the discomfort with over-the-counter medication. If the pain doesn’t go away, or gets worse, see a healthcare professional to be sure there is no serious injury, such as a fracture to the toe.

When to Get Medical Advice

Any pain or injury that doesn’t get better, or that is accompanied by an infection, will usually require professional medical attention. Symptoms of infection can include pus, skin that is warm to the touch, and swelling around the toenail. Treatment typically involves a course of oral antibiotics or a skin cream, although this depends on the underlying issue.

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Discussion Comments
By GiraffeEars — On Feb 01, 2011

I have pain under my big toenail. It is mostly in the outside corner farthest from my other toes. The edge of my toe is swollen and tender. Is this a sign of an ingrown toenail?

By Babalaas — On Jan 30, 2011

When I was in high school I played basketball, and I suffered from ingrown toenails for almost my entire senior season. I did not miss a game, but the pain was definitely unpleasant to say the least. I tried all of the ingrown toenail treatments, but the toenail was so ingrown that it would not grow out. In the end, I had to have a podiatrist perform toenail surgery, cutting almost my entire toenail off. It took a few months for it to grow back, but it has been fine ever since. Since the surgery, I have not had an ingrown toenail. If I would have known the treatment was so easy, I would have had it done before the season was even over.

By chicada — On Jan 29, 2011

Impacts and tight shoes can also cause in grown toenails. Constantly wearing the same pair of shoes or wearing shoes all day long can also increase your chances of getting an ingrown toenail or toenail infection. The moisture that builds up in shoes that do not breathe is the perfect breeding ground for infectious bacteria and fungus. The squeeze of tight shoes also causes the toenail to rub on the toe, causing it to curl in on itself. Big toenail pain is horrible, but if you take preventative measures, it is often avoidable.

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