Why does my toenail hurt so bad?

December 3, 2008 6:17 AM

Oh man does my toenail hurt! What could it be?

So I woke up this morning in some pretty bad pain. The center of my big toenail absolutely hurts! It's bad enough to keep me from sleeping or doing pretty much anything else. What's the deal with this?

It's the center of my toenail, so it's not an ingrown nail, right? When I push on the edges, they feel fine. But if I push downward on the very center top of the nail, yeowch! I'm pretty miserable at the moment.

I haven't stubbed my toe so far as I'm aware, none of the others hurt, I've pretty much only been wearing sandals the past few days, the coloration seems fine so far as I can tell through my nailpolish (no remover handy, and I don't think I could stand to rub on my toenail to take the polish off right now anyways).

Please, what can I do? Googling is useless, all I get are things about ingrown nails or runner's nails.

posted by internet!Hannah to health & fitness (9 comments total)

Could be that you've driven something (a tiny splinter, or a piece of dirt) under the nail whilst wearing sandals. I know that can cause the painful symptoms you've mentioned. But really, it could be any one of a number of things. If it doesn't improve in a day or so, see a doctor.
posted by le morte de bea arthur at 6:35 AM on December 3, 2008

It could also be an inflammation of the nail bed. I had that a few months ago and it hurt so much that I had trouble walking. At first it just hurt a little and was red, then the edge of the bed started filling with pus and was generally gross and painful. However, after about a week or so it was fine again. It's essentially a tiny cut that gets contaminated and leads to an inflammation (the German expression is Nagelbettentzündung, but the only translation I can find is onychia [slightly gross picture]- not sure whether that's exactly the same thing).

I agree with le morte de bea arthur, you should keep an eye on it and if it doesn't get better, see a doc. If it's the same thing I had, your body should be able to take care of this itself, but you could speed the process along with antibacterial cremes, I guess. You should remove the polish, though, and have a look.
posted by Bearded Dave at 7:53 AM on December 3, 2008

If you do see a doctor, I suggest a podiatrist. They're foot specialists and have seen just about everything that can go wrong with feet. A GP might just say, 'Yeah, it's a toe. Here's some ibuprofen."
posted by workerant at 8:43 AM on December 3, 2008

Could it be The Gout?

Of course a doctor will know best.
posted by pazazygeek at 8:57 AM on December 3, 2008

you should really go get some nail polish remover and remove the polish. then you'll actually be able to see if it's bruised or discolored or there's a stabby thing in it.

when in doubt, do a warm saline foot soak.
posted by misanthropicsarah at 9:16 AM on December 3, 2008

Could it be The Gout?

As someone who once had that legendary ailment, it sounds unlikely. Gout is characterised by an inflamation around the joint; it's not something that would only hurt when pressure is applied to the top of the nail.
posted by le morte de bea arthur at 9:36 AM on December 3, 2008

Is it possible you bruised it somehow? I had very similar symptoms once from wearing cleats a size to small. No discoloration but my toe hurt so much it was hard to do anything. After a couple days it turned black and blue and a couple weeks later it fell off. No permanent damage, but man did it hurt at first. Once it got to turning black and blue and falling off it didn't hurt at all.

I had the same experience when breaking in ski boots as well.

Of course you've been wearing sandals lately so this seems unlikely to be the explanation but I thought I'd toss it out there.
posted by pombe at 11:07 AM on December 3, 2008

Huh, I don't know what the deal was. My only guess is that I kicked the wall in my sleep or something. I wrapped it with a semi-frozen freeze-pop (hey, a poor college student does with what a poor college student has) and took some ibuprofen and now it's somewhat when touched, as opposed to horribly throbbingly painful all of the time.

I've got an appointment with the school clinic in two days, so if it's still an issue then, I'll see what they have to say. And my nail polish is very thin and pale, so unless any discoloration is very light, there isn't any.
posted by internet!Hannah at 3:05 PM on December 3, 2008

It's possible to bruise the tissue under the nail (the nail bed) without damaging the surrounding area. If you do this badly enough it gets pretty obvious, because you develop a sort of blood blister under the nail (common if you hammer your thumb), but it doesn't strike me as totally impossible that you might have done it hard enough to hurt, but not hard enough to be obvious through your polish. I can't imagine doing it in one's sleep, but hey, everybody's different...

I second others who have suggested removing the polish. (Maybe if you got some seriously strong remover, you could take it off without too much pain and scrubbing? I've heard acetone-based stuff is the best but can't confirm that myself.)

The fact that it's gotten better, rather than worse, with time suggests to me that it's a bruise or other injury that's healing on its own, rather than a foreign object trapped under there, which I'd imagine would get worse as it got more inflamed. But you should definitely see a medic of some sort about it. It sounds stupid, but toenail problems can get really debilitating: it doesn't take much to create an injury that hurts enough to make you limp pretty badly.
posted by Kadin2048 at 8:19 PM on December 6, 2008