Toenail pain
introduction
Toenail pain can occur at any age, in any person without any previous illnesses. Usually the pain affects not only the toenail but also the surrounding area. The toenail itself is not sensitive to pain as the nail itself does not contain any pain fibers. This is a good thing because otherwise we would have pain every time we cut our toenails. The pain occurs in the surrounding skin area of the toenail and can have many causes.
causes
Toenail pain is very stressful for the patient, as it can often no longer occur without pain. The causes of the pain are many. We have put together an overview of the most common causes for you.
- Ingrown toenail
- Athlete's foot or nail
- Inflammation of the nail bed
- Bruise under the toenail
Ingrown toenail
The term “ingrown toenail” is self-explanatory: the nail does not grow forward but into the side of the nail, which can lead to severe pain. In medical terminology, the term is also used as a synonym Unguis incarnatus used. Some patients are predestined for ingrown toenails due to their anatomical toe shape, while other patients are spared such problems. The most common risk factor for the development of an ingrown toenail is the wrong nail clipping. False means that the toenails are cut too short and rounded at the corners. It is correct to have a straight end to the toenails so that the corners also tend to end in the area of the toe tip. In addition, shoes that are too tight can provoke the development of an ingrown toenail.
Patients with diabetes mellitus are also particularly at risk. Since the blood flow to the feet is not optimally guaranteed in diabetics, the oxygen supply to the tissue can be reduced particularly quickly. This leads to an inflammatory reaction which, in addition to inflammation of the nail bed, can also lead to an ingrown toenail. The inflammatory tissue is usually swollen, red and overheated. The pain is typically pulsatile and pressure can make it worse. There is always the possibility that the inflammation will develop into inflammation with pus formation or that it will spread to surrounding and deeper structures. Accordingly, the pain increases and there is a risk of so-called phlegmon developing. This is a soft tissue infection caused by a bacterial inflammation of the connective tissue.
Most of the time, the big toenail is affected, although it cannot be ruled out that the smaller toenails can also grow in.
Read more on the topic Ingrown toenail
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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
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Nail fungus as the cause
A nail fungus is also known as nail mycosis or onychmycosis in the medical field. If a nail fungus is present, an infection has occurred due to a specific fungus in the toenail area. In general, the nails on the toes are more often affected than the fingernails.
Different pathogens can be the trigger: thread, yeast and mold. The last two fungi mentioned tend to be the cause of nail fungus less often. If a nail fungus develops on the floor of a filamentous fungus colonization, one can also speak of a so-called tinea unguium in this special case.
The fungal attack usually spreads from the front edge of the toenail towards the nail bed and initially only affects one toenail. In addition to the pain on the affected toenails, discoloration, mostly white, yellow or grayish, is typical. In addition, the toenail is dull and brittle, so that it can crumble and decay.
The pain is a secondary cause of the nail fungus. On the one hand, the nail architecture can change as described above and also become thicker. This leads to an increased pressure load in the nail bed, which is accompanied by a painful stimulus. In addition, due to the spatial proximity, the pathogens can also spread to the skin of the toes and cause inflammation there. This also causes pain.
Small lesions, which were often seen as the entry point for the pathogen, can also turn into inflammatory tissue and be painful. The pain of a nail fungus is generally considered to be a symptom in the late stage. It is therefore important to identify and treat nail fungus in good time based on the visible changes in the nail.
Risk factors for the development of a nail fungus are shoes that are too tight, misalignment in the foot and toe area and certain pre-existing conditions such as diabetes mellitus and circulatory disorders.
A worsening of the symptoms, especially the pain, with existing nail fungus, can be provoked by the following factors: shoes that are too tight, excessive perspiration, inflammation of the skin, small injuries / open areas in the toe area and diseases that weaken the immune system.
Read more on the topic Symptoms of a nail fungus
Inflammation of the nail bed
Inflammation of the nail bed can also be the cause of severe pain in the toenail. As the word already implies, inflammation in the area of the nail bed occurs due to a viral or bacterial infection or due to an infestation with fungi. In contrast to an ingrown toenail, which can be localized to one spot, an inflammation of the nail bed is often spread over the entire area of the toenail and can be surrounded by pus.
Bruise under the toenail
If a toenail turns blue or bluish-purple, this indicates a bruise, i.e. a pool of blood, under the toenail.
This change in the toenail is very often associated with pain. The causes of a blue toenail are many.
However, the mechanism is usually that the toenail is exposed to increased pressure over a longer period of time. Such pressure is very often caused by the wrong footwear. A shoe that is too tight means little space for your feet, so that after a long hike, frictional pressure on the toenail provokes a bruise. But shoes that are too big can also be harmful. Especially when walking downhill, those affected slide a little forward in the shoe with every step, so that the toes hit the tip.
However, pain in the toenail with accompanying blue coloration can also be the result of trauma. The toenails bump into a step or edge or heavy objects falling onto the toenails are quite banal. This leads to the immediate perception of pain, which subsides a little over time. If there is a pronounced bruise, pain relief can be achieved through relief by pricking the toenail in the area of the bruise with a small sterile needle. This allows the bruise to drain and the pressure pain subsides due to the volume reduction. In addition, the toenail can be preserved with this procedure, otherwise the toenail usually falls off.
In general, a blue toenail either falls off or the bruise grows out. In summary, it can be said that pain with a blue toenail can be caused by the blood deposition under the toenail itself (pressure pain), or secondarily by an inflammatory change (inflammation pain) or swelling of the surrounding tissue (pressure pain).
Read more about Subject bruise under the nail
diagnosis
The diagnosis of an ingrown toenail can usually be made by the patient himself, as he recognizes the ingrown toenail and also has severe pain in the corresponding areas. In itself there is also a Inflammation of the nail bed can be seen very well, but the patient cannot make the diagnosis as to whether it is a bacterial, viral or mycotic conditional nail bed inflammation. However, since this decision is important for the further course of therapy, a doctor should be consulted with the help of smears or Blood tests can determine which pathogen is responsible for the nail bed inflammation in order to then enable an adequate therapy.
Symptoms
Besides the Pain in the toenail there is also an ingrown toenail Redness and swelling in the affected area.
If the nail bed is inflamed, the area around the nail swells a lot, is reddened and, in worse cases, forms Pus vesicles. With light pressure there is severe pain. In the case of bacterial inflammation of the nail bed, it can also fever and Night sweats come, which then indicates a worse course of the with Antibiotics should be treated. In rare cases there is also one Swelling of the lymph nodes.
therapy
Therapy for pain in the toenail is essential. It is particularly important not to experiment yourself until you come to a reasonably good solution at some point, as in most cases you worsen the course of the disease and thus the pain in the toenail and hinder the healing instead of supporting it.
If you have an ingrown toenail, it is important to get professional help. You shouldn't use a beautician's pedicure, but a trained podiatrist, i.e. medical foot care. Not only is the ingrown nail removed or processed, depending on the severity, but the nail is also trimmed so that there should be no further problems afterwards.
Also, a medical podiatrist can provide practical tips to help prevent re-ingrown toenail and the pain that comes with it.
If the pain arises due to an inflammation of the nail bed in the toe, the family doctor should be consulted so that he can decide on further therapy. It is important not to experiment with ointments or tinctures on the toe yourself. In the initial stage, you can try to calm the inflammation with foot baths (preferably with chamomile, as this has an anti-inflammatory (anti-inflammatory) effect). Ointments that either also have an anti-inflammatory effect or have disinfecting components, such as povidan iodine, also help.
Depending on the pathogen, the doctor can also prescribe an antibacterial, antiviral or antifungal cream, which then works specifically against the inflammatory germ. If the patient also has a fever, antibiotics should also be given to prevent the bacterial inflammation from spreading. In addition, the doctor should open them up in larger foci of pus and then clean the toe with disinfectants and then apply a healing cream (for example with chamomile) and then bandage it so that no new germs can penetrate the wound.
In rare cases, the toenail has to be removed, which can initially worsen the pain in the toenail area, but is promising in the long term.
prophylaxis
A simple one prophylaxis for toenail pain is a good one Foot care. The feet should be regular in one Foot bath and patients who are prone to ingrown toenails or Inflammation of the nail bed should see medical foot care regularly. Also can Creams with chamomile extracts the health of the Toes promote and thus prevent pain in the toenail. In addition, it is essential to make sure that the toenails are trimmed correctly so that they cannot stick together.
forecast
The prognosis for pain in the toenail is usually very good, but it can depend on Underlying disease take longer for the inflammation and thus the pain to heal completely. Also, some patients experience because of anatomical events, such as a crooked toe shape, repeatedly develop adhesions, which then lead to pain in the toenail. With the right therapy and good prophylaxis, one can relieve the patient's pain and make pain less frequent.
Toenail pain after hiking
The appearance of Pain after long walks is not uncommon. In most cases, the explanation is very simple: wrong footwear.
If the shoes are too small or too big, the toes are one of them on longer hikes exposed to enormous pressure and friction. Continuous irritation can cause a Provoke a bruise and the surrounding tissue in the form of Inflammation and swelling to include.
Hence it is important that the suitable shoe size to choose and to lace the shoes properly so that the foot has a firm hold. Otherwise the foot will be constricted or slip back and forth if the shoes are too big. Especially when walking downhill, the tips of your toes hit the front and a painful bruise can form.
It should be noted that on longer hikes, the feet through the Load slightly swellso that the shoes must not be too tight at the beginning of the hike. Other factors that can provoke pain in addition to the wrong or bad shoes are to thin socks, Misalignment such as flat feet or toe deformities like the so-called hallux valgus. This is an incorrect posture in which the big toe deviates extremely towards the middle of the foot and, after a kink has formed from the base joint, points in the direction of the remaining toes. In the case of known misalignments of the feet and / or toes, it is advisable to do a planned, long hike special insoles for the shoes to use.
