When pressure causes pain in a toenail, an ingrown nail is often suspected. However, discomfort when pressing on a toenail can stem from various other common conditions. This article explores different reasons your toenail might hurt when pressed, beyond the typical ingrown nail.
Identifying Potential Causes
Trauma, from sudden impacts like stubbing a toe or dropping an object, can cause a subungual hematoma. This occurs when blood collects under the nail, leading to throbbing pain due to increased pressure. Minor, repeated impacts, such as from sports or ill-fitting shoes, can also cause this bruising, often called “runner’s toe.”
Fungal infections (onychomycosis) can cause toenail pain. They often lead to nail changes like thickening, discoloration (yellow, white, or brown), and a crumbly texture. As the infection progresses, the nail can thicken and separate from the nail bed, creating pressure and pain, especially when external force is applied.
Nail psoriasis, an autoimmune condition, can affect both fingernails and toenails, causing tenderness and pain. It can lead to structural changes like pitting, discoloration, thickening, and separation of the nail from its bed (onycholysis).
Footwear plays a significant role in toenail pain. Tight, narrow shoes or those lacking adequate toe box space compress the toes, exerting continuous pressure on the toenails. This constant friction and compression can lead to irritation and pain. Activities involving repetitive pressure, such as running or hiking downhill, can also cause microtrauma and pain to the nail bed.
Less common causes include bony growths under the nail. A subungual exostosis, or bone spur, is a bony projection that forms beneath the toenail, often due to repeated trauma. As it enlarges, it can distort the nail and cause pain when pressure is applied, such as during walking or wearing shoes.
Home Care and Prevention
Managing toenail pain often begins with simple adjustments to daily habits. Selecting appropriate footwear is a primary step. Choose shoes with ample toe box room to prevent compression and friction. Avoiding narrow or pointed toes and high heels can significantly reduce pressure on the nails.
Proper nail care also prevents discomfort. Trim toenails straight across, avoiding rounded edges, to prevent skin irritation. Do not cut nails too short, as this exposes the sensitive nail bed to pressure. Maintaining good foot hygiene, including keeping feet clean and dry, protects nail health and prevents issues like fungal infections.
For acute pain or swelling, resting and elevating the affected foot can help reduce discomfort. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may also provide temporary relief. Soaking the foot in warm water, potentially with Epsom salts, for 15 to 20 minutes can soothe the area and reduce swelling.
When to Consult a Doctor
While many causes of toenail pain can be managed with home care, certain signs indicate the need for professional medical evaluation. Seek medical advice if pain is persistent, worsens despite home remedies, or significantly impacts your ability to walk comfortably.
Signs of infection, such as increasing redness, warmth, swelling, pus, or fever, warrant prompt medical attention. Any unexplained or spreading discoloration under the nail, especially dark streaks, should also be evaluated. If the nail shows significant structural changes like lifting, severe thickening, crumbling, or other deformities, a healthcare provider can diagnose the underlying issue.
Individuals with underlying health conditions, including diabetes, poor circulation, or a compromised immune system, should consult a doctor for any foot or toenail problem. These conditions increase the risk of complications from minor foot issues, making professional assessment and timely intervention important.