Why do my toes and toenails hurt?

Article 1 – ingrown nail series

Toes and toenails hurt for a number of reasons, the most common causes include ingrown toenails, bunions, cuts or scrapes, blisters, corns and calluses, infections and trauma or injury. Toe joint pain can include arthritis such as rheumatoid arthritis, gout, osteoarthritis. Further information found at foot, ankle and leg pain.

The toenail

The toenails are thickened extensions of the top layer of our skin and are made of the same tough protein, called keratin. We have them on the end of all of our toes. The purpose of a toenail is to protect the distal soft tissues of toes from physical trauma of everyday life. 

Anatomy of a toe

When we look at our toes the most visible part is known as the nail plate. At the top of the nail is soft tissue surrounding and protecting it called a cuticle. Beneath the nail plate is our nail bed, and beneath the cuticle is the matrix. The matrix is composed of living cells that produce keratin. The keratin forms the nail cells. All of this is closely connected to the blood vessels and numerous nerves of the nail bed.

Why do my toenails hurt?

Toenails hurt when the shape, condition or position of them affects the toe. For example, if you were to sit with a thick book on your head it would hurt after a while, the same can be said for pressure on a toe from a thickened nail. 

Toenails hurt due to nail shape and texture

  • Ingrown nails causing long term pain and possible infection
  • Involution causing ingrown nails leading to bacterial infections
  • Flat causing ingrown nails leading to bacterial infections
  • Thickened causing pain from pressure as it gets thicker
  • Splitting, peeling, or brittle nails

Toenails hurt due to the condition of the nail

  • Fungal infection causing thickening or/and involution
  • Picked or bitten can lead to ingrown nails and infection
  • Trauma such as stubbing or dropping something on it
  • Micro trauma such as running with long nails or running down hill
  • Separation from the nail bed
  • Chemotherapy drug changes to nails
  • Nail changes from psoriasis, peripheral arterial disease and others conditions

Why do my toenails look different to others?

The shape of the nail is determined by the shape of the bone in the toe; however the nail shape can be influenced by other factors such as skin conditions, infections, trauma, medicines, systemic illnesses.

  • Detachment (onycholysis) can be affected by excess keratin, inflammatory changes or infection
  • Thickening may occur as a result of inflammatory, traumatic and infective conditions, nail bed thickening
  • Clubbing of nails can be caused by low oxygen levels in the body in chronic lung conditions
  • Concave nails.This occurs when body is deficient of iron 
  • Pitting can be a sign of Psoriasis
  • Discolouration can be caused by trauma, infective conditions and cancer OR nail varnish damage
  • Ridging (transverse, longitudinal)
  • Ingrown due to nail shape, trauma, poor footwear

What should I do if I am worried about my toenails or if the toenails hurt?

Podiatrists are the foot and ankle experts. We study dermatology of the feet and the nails in particular. We can diagnose, advise and treat a range of nail conditions including nail surgery with local anaesthetic.

At Zest Podiatry & Physio we pride ourselves in being able to help with many nail conditions, we are experts in nail surgery and are always happy to help you. Contact us or book an initial appointment online.

Ingrown nail series Articles

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