Why do I have pain in toenails ? And what are the conditions associated with it?

Mostly, toenail pain comes with a bruise under your nail, a black toenail, or infected skin around the toenail. The toenail pain can be caused due to an ingrown toenail, a fungal infected toenail, or any trauma-related wound to the toenail that can cause blood under the nail.

There are many conditions that can cause mild to severe pain under and around your toenail. This pain can make it problematic to put on shoes and walk around. Usually the nail fold, as the skin around the toenail, is also involved. Symptoms associated with toenail pain include the following;

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

What causes toenail pain?

There are numerous causes of toenail pain. Fortunately, different causes of toenail pain can be treated and then prevented easily from recurring. Some of them are mentioned as follow;

Ingrown toenail

When a toenail grows again after being cut, the edge can grow into the nearby skin. It causes pain, inflammation, and redness. Sometimes an injury to the nail fold can cause infection and chronic inflammation.

Infectious causes

Bacterial infection; an acute or chronic bacterial infection can cause pain, redness, and swelling, accompanied by pus noticeable under your skin next to the toenail.

Fungal infection; fungal infection to one or more toenails is a common condition (onychomycosis). It causes toenails to become thick and yellow in color and nails may start to crumble. In more severe cases, the toenails will become very aching. Furthermore, it can be difficult to completely get rid of this toenail infection.

Trauma-related causes

The foreign body; as severe toenail pain can also be caused by any sharp object, like a wooden splinter, can become wedged under your toenail.

Bleeding under the toenail; any trauma to your toenail can also cause blood collecting beneath the nail. Thus, creating a red or black color. Hence, increased pressure beneath the toenail caused by the blood can be painful.

Other injuries; the toe can be crushed or cut by any object which leads to a painful injury. Therefore, some or all the toenail may get torn off from the toe.

Tumor-related causes

Several types of benign tumors can form beneath the toenail. These tumors can cause pain and toenail separation from the toe.

Systemic disease causes

There are some chronic diseases that can affect the skin and toenails. Thus, causing pain and changes in the structure of the nails. These diseases comprise sarcoidosis and psoriasis.

Other diseases, mainly those which cause decreased immune system functioning, can cause a predisposition to painful toenail problems like a fungal infection.

Possible toenail pain conditions

Typically, toenail problems can affect people of almost all ages, but more common in older people. Common conditions associated with toenail pain include poor nerve supply, trauma, ill-fitting shoes, poor circulation, and infection.

Nail infection (paronychia)

It is a skin infection of the fingers or toes. It occurs at the place where the skin folds down to meet the nail. Acute paronychia is caused by staphylococcus bacteria. Therefore, this organism can easily gain entry if the nail is broken, cracked, bitten, or trimmed too closely.

However, chronic or ongoing paronychia is caused by a fungus. Individuals with diabetes or a weakened immune system are more prone to nail infections. Its symptoms include sore, swollen skin around the nail, sometimes pus under the skin.

Chronic idiopathic peripheral neuropathy

Peripheral neuropathy involves the feeling of tingling, numbness, and sensation of pins-and-needles in the feet. There is no cause of idiopathic neuropathy.

This condition is often found in individuals over age 60. Symptoms consist of lack of normal sensitivity, numbness and burning in the feet, trouble walking, and weakness in the muscles of the feet and ankles.

It can greatly interfere with the quality of life, thus a medical provider should be seen to treat the symptoms and diminish the distress.

Skin infection of the foot

Foot infection is almost always either fungal or bacterial. Fungal foot infection is called tinea pedis or athlete’s foot. Different types of dermatophyte fungus are responsible for this infection. And it is commonly found in damp places like showers or locker room floors.

A bacterial infection on the skin if extends under the skin is called cellulitis. Therefore, it can develop after any disruption in the skin which allows bacteria to enter and grow. Most often, these bacteria are either Streptococcus or Staphylococcus. These bacteria are found throughout the environment.

Diabetic patients are most susceptible since high blood sugar inhibits healing and wounds can become chronic or deeply infected. Its treatment involves keeping the skin dry and clean at all times.

Toe bruise

Toe bruise is the damage of the blood vessels that return your blood from tissues back to the heart. Therefore, the blood pools there and turns bluish or purplish in color. Typically, it’s caused by a hit, bump, or fall. But it is rare.

Its top symptoms include toe injury, constant foot pain, toe pain from any injury, swollen toes, toe bruise.

Tarsal tunnel syndrome

This syndrome refers to the symptoms which occur due to compression of the posterior tibial nerve which provides sensation to the bottom of the foot. It also controls some of the muscles involved in foot movement and structure.

Raynaud phenomenon

It is also called as Secondary Raynaud syndrome. It is a condition that causes small arteries in the skin to unusually tighten on exposure to air or cold water. Therefore, this confines blood flow to the feet, toes, hands, fingers, nose, and ears.

Secondary Raynaud syndrome is caused by another underlying medical disorder, often a connective tissue disorder like rheumatoid arthritis, scleroderma, or lupus. Women are more likely to be affected than men, particularly those living in cold climates.

Best Treatment For Toenail Fungus of 2019

Its symptoms include the hands and feet becoming cold and numb. Further, your skin color may change from pale to bluish, and then to reddish as the skin warms again.

Athlete’s foot (tinea pedis)

Athlete’s foot is a very common fungal infection of the feet or toes. The most common causes of this type of infection involve moist, warm environments and community showering.

Its top symptoms include foot skin changes, foot redness, foot or toe itch, spontaneous foot pain, and peeling between the toes.


A joint deformity that occurs at the base of the big toe is called a bunion. There are certain footwear styles which can worsen bunions. This deformity is also very common.

Its symptoms include big toe pain, bump on outside edge of a big toe, toe pain which gets worse in closed-toe shoes, foot ulcer, pain at the base of the toe.

The final word

Healthy nails look smooth and have constant coloring. You may develop vertical ridges as you age, or your nails may become slightly stiffer. This is harmless.

Abnormalities like spots, discoloration, and nail separation can occur due to injuries to the fingers and hands, infections, and some medications (chemotherapy).

Hence, the appearance of your fingernail alone isn’t enough to detect a specific disorder. Your doctor will use exact information, with your other symptoms and a physical exam, to make a proper diagnosis. Therefore, you should consult your physician if you have any queries about changes in nails.

Areeba Hussain

Areeba is an independent medical and healthcare writer. For the last three years, she is writing for Tophealthjournal. Her prime areas of interest are diseases, medicine, treatments, and alternative therapies. Twitter @Areeba94789300

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