WHERE DOES IT HURT ?
A thick discolored toenail can arise from cutting the edges improperly, tight fitting shoes or from trauma and fungal toenails.
Pain ranges from dull to sharp depending upon the level of irritation and compression of the nail.
Ms. Montgomery approached our clinic with a fungal toenail infection and concerns about her thick, dark nail condition and wearing sandals. I always instruct my patients that the thickness is from shoe pressure and may not go away with the Lamisil treatment, but the discoloring will go away. Her nails not only cleared up, but they were back to their thin soft shape after the treatment and wearing sensible shoes.
A larger, softer shoe can relieve the direct or indirect pressure. Make sure that the shoe has enough room at the end about the width of your thumb and that the toe box (front of the shoe) is high enough to allow your toes to move freely.
Cutting the nail edges straight across without cutting the corners will prevent the skin at the edges from growing over the nail (becoming an ingrown toenail). Once the nail is ingrown, the painful edge(s) can be angled at the end by a professional to temporarily relieve the pressure and/or infection.
There is an array of over the counter pads that can be placed between the toes or behind the painful nail edge to relieve the pain associated with ingrown toenails.
Nail softening products (topical creams, gels, solutions) can ease the pain and pressure of the painful ingrown toenail. Antibiotic medication may be necessary for acute infections.
The nail can be removed to relieve the pressure and infected tissue. Topical anti-fungal medication is then applied until the nail completely returns. If the nail thickness and pain persists, a chemical can be applied to the nail root and prevent the nail from returning.
The procedure is performed in the office with local anesthetic or occasionally at an out-patient facility under sedation (e.g. young children, anxiety, bone infection). Full weight bearing is allowed immediately without restrictions.
These are links to more information on the subject, not intended to imply an endorsement.
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