Ingrown toenail removal is a common procedure performed to alleviate chronic pain and infection caused by the nail edge growing into the skin. While the surgery provides long-term relief, it is normal to experience tenderness, throbbing, and discomfort in the toe, particularly within the first 24 to 48 hours after the local anesthetic wears off. Managing this immediate post-operative pain involves controlling inflammation and protecting the surgical site.
Managing Acute Pain with Medication
The initial discomfort following the procedure is best managed through over-the-counter (OTC) pain relievers. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are recommended because they not only target pain but also reduce inflammation and swelling at the surgical site. Acetaminophen works by raising the body’s pain threshold and can be used in combination or alternation with an NSAID if a doctor approves a staggered dosing schedule.
Follow the dosage instructions precisely to maintain a steady level of pain control. Taking the medication before the pain becomes severe is more effective than waiting for intense discomfort. Prescription pain relievers are reserved for cases involving significant pain or for the immediate 12 to 24 hours following the procedure. These stronger options are discontinued quickly as the acute post-operative pain subsides.
Immediate Physical Comfort Techniques
In addition to medication, several physical techniques can reduce throbbing and swelling in the toe immediately after the surgery. Elevating the foot above the level of the heart for the first one to two days is effective as this position uses gravity to reduce blood flow and fluid accumulation at the surgical site. This decrease in localized pressure helps to lessen the intense throbbing pain.
Applying cold therapy also helps manage swelling and pain by constricting blood vessels. An ice pack should be wrapped in a thin towel and applied to the area for 15 to 20 minutes at a time, with breaks in between applications to protect the skin. After the initial 24 to 48 hours, soaking the foot in warm water, potentially with Epsom salts, may be recommended by a doctor to soothe the toe and aid in the removal of the initial dressing. These soaks last 10 to 15 minutes and should be followed by thoroughly drying the toe.
Protecting the Healing Toe
Ongoing care of the surgical wound is essential to prevent secondary pain caused by infection or trauma. The initial dressing applied by the doctor protects the wound and should remain intact for the first 24 to 48 hours. Once the doctor advises removing the first dressing, a routine of gentle cleansing and re-dressing must be maintained.
Daily dressing changes involve washing the toe with warm water and mild soap, patting it dry, and applying an antibiotic ointment before covering it with a fresh, sterile, non-adherent dressing. Avoiding direct pressure on the toe is necessary; this means wearing open-toed shoes, loose sandals, or post-operative footwear for at least one to two weeks. High-impact activities, like running or jumping, must be restricted during the initial recovery period because the repetitive forces can cause internal trauma and pain, delaying the healing process.
When to Contact Your Doctor
While some pain and a small amount of clear or light pink drainage are normal after the procedure, certain symptoms indicate a complication. Any pain that suddenly worsens or becomes severe after the first few days, instead of slowly improving, is a warning sign. The local anesthetic may cause temporary numbness, but tingling that persists long after the procedure is complete should be reported.
Signs of a developing infection include increased or spreading redness and warmth around the toe, a persistent fever, or the presence of thick, yellow, or foul-smelling discharge. The appearance of pus or a bad odor from the wound signals a localized bacterial issue. If you experience chills or flu-like symptoms alongside these local signs, it may suggest the infection is spreading.