Read below about toenail pain, including causes, treatment options and remedies. Or get a personalized analysis of your toenail pain from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

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Toenail Pain Symptoms

Certain conditions can cause mild to severe pain under and around a toenail. The pain can make it difficult to put on shoes and walk around. Often the nail fold, meaning the skin just around the toenail, is involved as well. Luckily, many causes of toenail pain can be easily treated and then prevented from recurring.

Symptoms that can be associated with toenail pain include:

  • Drainage
  • Swelling
  • Redness of surrounding skin
  • Toenail thickening
  • Toenail crumbling
  • Yellow toenail
  • Red/black toenail
  • Separation of the toenail from the toe
  • Unpleasant smell

Toenail Pain Causes Overview

Ingrown toenail:

  • When a toenail grows back after being cut, the edge can grow into the surrounding skin. This results in pain, swelling, and redness. Sometimes the injury to the nail fold will lead to infection and chronic inflammation.

Infectious causes:

  • Bacterial infection : An acute or chronic bacterial infection of the nail fold can cause pain, redness, and swelling, along with pus visible under the skin right next to the toenail.
  • Fungal infection : An infection of one or more toenails by fungus is a common condition (onychomycosis). The affected toenails will be thick and yellow in color and may start to crumble. In severe cases, the toenails will also become painful. It can be difficult to completely get rid of a fungal toenail infection.

Trauma-related causes:

  • Foreign body : A sharp object, such as a wooden splinter, can become wedged under a toenail and cause severe toenail pain.
  • Bleeding under the toenail : Trauma to the toenail can result in blood collecting beneath the nail, creating a red/black color. Increased pressure beneath the toenail caused by the blood can be very painful.
  • Other injury : The toe can be cut or crushed by an object, leading to a painful injury involving the toenail. Some or all of the toenail may get ripped off from the toe.

Tumor-related causes:

  • Multiple types of benign tumors can form underneath the toenail, causing pain and separation of the toenail from the toe.

Systemic disease causes:

  • Some chronic diseases can affect the skin and toenails, causing pain and changes in the structure of the nails. These include sarcoidosis and psoriasis.
  • Other systemic diseases, particularly those that cause decreased functioning of the immune system, can cause a predisposition to painful toenail problems such fungal infection.

A.I. Health Assistant Causes for Toenail Pain

Updated on Aug. 29, 2018

The list below shows results from the use of our A.I. Health Assistant by Buoy users who experienced toenail pain. This list does not constitute medical advice.

  1. 1.Nail Infection (Paronychia)

    Paronychia is an infection of the nail folds, typically caused by Staph. Aureus. Or a fungus.

    Great prognosis. Recovery in the next two weeks

    Rarity:
    Rare
    Top Symptoms:
    spontaneous finger pain, fingernail pain, fingernail swelling
    Urgency:
    Phone call or in-person visit
  2. 2.Chronic Idiopathic Peripheral Neuropathy

    Nerve damage in the limbs can be caused by diabetes, toxic substances, immune system issues and low vitamin levels. However, in about one of every four cases no cause can be found and then the condition is called 'idiopathic'. Symptoms of nerve damage can be (burning) pain sensations, numbness, tingling and weakness in hands, feet or lower legs.

    This is a chronic condition.

    Rarity:
    Rare
    Top Symptoms:
    distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass
    Urgency:
    Primary care doctor
  3. 3.Skin Infection of the Foot

    Cellulitis is a common and possibly dangerous skin infection if left untreated. It is typically caused by bacteria living on the skin getting into the skin itself.

    5 days with treatment

    Rarity:
    Uncommon
    Top Symptoms:
    fever, foot pain, foot redness, warm red foot swelling, swollen ankle
    Symptoms that always occur with skin infection of the foot:
    foot redness, foot pain, area of skin redness
    Urgency:
    Primary care doctor
  4. 4.Toe Bruise

    Toe contusion (bruise) is the damage of the blood vessels (veins and capillaries) that return blood from your tissues back to the heart. The blood pools there and turns blue or purple. It's typically caused by a bump, hit, or fall.

    2-3 days

    Rarity:
    Rare
    Top Symptoms:
    constant foot pain, toe injury, toe pain from an injury, swollen toes, toe bruise(s)
    Symptoms that always occur with toe bruise:
    toe pain from an injury, toe injury, constant foot pain
    Urgency:
    Self-treatment

    Toenail Pain Checker

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  5. 5.Tarsal Tunnel Syndrome

    The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. Tarsal tunnel syndrome is a compression, or squeezing, on an important nerve called the posterior tibial nerve. This compression produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.

    Tarsal tunnel syndrome is a long-term condition that may need to be managed for months up to 1-2 years.

    Rarity:
    Ultra rare
    Top Symptoms:
    tingling foot, pain in one foot, spontaneous foot pain, heel pain, pain in the top of the foot
    Urgency:
    Primary care doctor
  6. 6.Raynaud Phenomenon

    Primary Raynaud phenomenon is a disorder of the blood vessels, usually in the fingers and toes, which causes the blood vessels to narrow when feeling cold or stressed. When this happens, blood can't get to the surface of the skin and the affected areas turn white and blue.

    This condition is considered irreversible, but it should not prevent you from living a healthy life.

    Rarity:
    Common
    Top Symptoms:
    distal numbness, cold toe, cold fingers, spontaneous toe pain, spontaneous finger pain
    Urgency:
    Self-treatment
  7. 7.Athlete's Foot (Tinea Pedis)

    Athlete's foot is a common fungal infection of the feet and/or toes. Warm, moist environments and community showering are common causes of this type of infection.

    With treatment, athlete's foot should go away in about 2 weeks. However, it often comes back, especially if the same shower or bathroom are used.

    Rarity:
    Common
    Top Symptoms:
    foot redness, foot/toe itch, foot skin changes, spontaneous foot pain, peeling between the toes
    Symptoms that always occur with athlete's foot (tinea pedis):
    foot redness
    Symptoms that never occur with athlete's foot (tinea pedis):
    toe injury
    Urgency:
    Self-treatment
  8. 8.Bunion

    A bunion is a deformity of the joint at the base of the big toe. Certain footwear styles can worsen bunions.

    Generally, better footwear & orthotics can slow the bunion's progression and alleviate symptoms.

    Rarity:
    Common
    Top Symptoms:
    bump on outside edge of big toe, big toe pain, toe pain that gets worse when wearing closed-toe shoes, foot ulcer, pain at the base of the toe
    Symptoms that always occur with bunion:
    bump on outside edge of big toe
    Urgency:
    Primary care doctor

Toenail Pain Treatments and Relief

Most causes of toenail pain do not need require urgent treatment. However, some types of injuries should be evaluated quickly.

Seek immediate treatment if:

  • A foreign body has been wedged under the toenail, particularly a wooden splinter or other type of plant material like a thorn. These objects should be removed as quickly as possible to avoid severe infection and inflammation.
  • An injury has caused part or all of the toenail to come off of the toe.

In some cases, even though emergency toenail pain treatment isn't necessary, you should still seek medical evaluation.

Make an appointment with your medical provider if:

  • You have diabetes, in which case any foot infection can become severe.
  • You have any chronic medical condition that has affected your skin in the past, such as psoriasis.
  • You have redness and warmth surrounding the toe.
  • You notice pus draining from the toenail and surrounding skin.
  • Your pain is associated with a growth underneath the toenail.
  • Your toenails have thickened and changed in color.

Your medical provider may prescribe one or more of the following toenail pain treatments, depending on the cause of the toenail pain:

  • A splint to help separate an ingrown toenail from the surrounding skin.
  • Surgical removal of part or all of the toenail.
  • Drainage of infected fluid.
  • Oral antifungal or antibacterial medication.
  • Antibiotic cream.
  • Treatment for an underlying medical condition that is affecting the toenails.
  • A tetanus shot may be necessary if a foreign body such as a splinter is responsible for the pain.

Some home treatments may help with toenail pain symptoms.

  • Soak the toe in warm water.
  • Wedge a small piece of cotton or dental floss underneath the edge of an ingrown toenail.
  • Trim toenails regularly. Cut them straight across on top and do not attempt to trim around the edges.
  • Wear shoes that are the correct size (your toes should have a little bit of wiggle room).

FAQs About Toenail Pain

Here are some frequently asked questions about toenail pain.

Why do I keep getting a painful ingrown toenail?

Ingrown toenails are often caused by cutting the nails incorrectly. Make sure to cut toenails straight across the top and avoid rounding the edges. Ingrown toenails are also more likely to occur in the setting of sweaty feet and wearing shoes that are too small. Athletes may get ingrown toenails due to repetitive trauma from the toes hitting the front of the shoe.

Can toenail pain be caused by an infection?

Yes, a bacterial infection of the skin surrounding the toenail can be very painful. In this case there will be redness and swelling around the toenail, as well as pus visible beneath the skin and possibly drainage. The infection often starts due to an ingrown toenail. A severe fungal infection of the toenail can also be painful.

Can painful toenail conditions be caused by chronic medical problems?

Certain chronic medical conditions can cause abnormalities of the fingernails and toenails along with pain. For example, psoriasis is an inflammatory skin condition that can cause thickening, pitting, and separation of the nails. Chronic conditions that cause decreased blood supply to the feet, such as peripheral arterial disease and diabetes, can make the toenails more vulnerable to injury and infection.

What should I do if I have toenail pain because of a splinter?

A splinter or any other object wedged beneath the toenail can be extremely painful. It is important to get treatment quickly to remove any type of vegetation, such as a wooden splinter or cactus spine. These objects can cause severe inflammation and infection. A medical provider may cut a triangle shape out of the nail in order to completely remove the splinter.

Why is my painful toenail changing color?

There are a couple of conditions that can cause both toenail pain and color changes. A fungal infection can cause the toenail to turn a yellow/brown color, and can be painful. One type of bacteria that causes infection of the toenail and surrounding skin, called pseudomonas, can cause part of the toenail to turn a greenish color. In addition, a collection of blood under the toenail caused by trauma can make part or all of the toenail appear red or black in color.

Questions Your Doctor May Ask About Toenail Pain

  • Q.Have you ever been told you have flat feet?
  • Q.How would you explain the cause of your foot pain?
  • Q.Did you recently injure your foot?
  • Q.Has a bunion formed on your foot?

If you've answered yes to one or more of these questions, try our toenail pain symptom checker to find out more.

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Toenail Pain Symptom Checker Statistics

  • People who have experienced toenail pain have also experienced:

    • 28% Big Toe Pain
    • 5% Toe Pain
    • 4% Swollen Toes
  • People who have experienced toenail pain had symptoms persist for:

    • 32% Over a Month
    • 26% Less Than a Week
    • 22% Less Than a Day
  • People who have experienced toenail pain were most often matched with:

    • 40% Chronic Idiopathic Peripheral Neuropathy
    • 40% Skin Infection of the Foot
    • 20% Nail Infection (Paronychia)
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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