Pain on the Tip of a Toe

IngrownNailI have a pain on the tip of my big toe and it’s so tender. What is it?

From your explanation, it could be many things. The most common answer would be an ingrown toe nail but a enchondroma comes to mind as well. Enchondroma is a bump of bone that sticks out and can often hurt. They can grow under the nail and hurt very badly with any pressure at all to the nail.

An ingrown toenail can hurt at the tip of the toe but is more often seen on the side of the nail. Most people are able to identify an ingrown toenail themselves. Ingrown toenails can become infected and should not be left to “grow out.”

Many people and even doctors will advise patients to soak their toe when they get an ingrown nail. While this can help relieve symptoms, it also increases the potential of infecting the toe, putting the patient in a worse position than they were before. Antibiotic cream with a dressing, until you get this fixed, is your best course. Also, avoid any tight shoes or other activities that hurt, as this can not only make the area hurt, it can make the ingrown nail worse. If left long enough, the ingrown nail will form proud flesh (granuloma) that looks like tissue without skin covering it. This bleeds easily and can be very tender.

Correcting an ingrown toenail involves these steps:

  • An anesthetic is used to numb the area.
  • Clean the foot.
  • Removing part of the nail so that it is not digging into the flesh. On some nails, this only requires removing a small piece of nail, while others may require removing the whole nail due to the extreme curvature of the nail.
  • The toe is then covered with a dressing and can then be allowed to heal. If the curvature or shape of the nail is too deformed to grow back without digging in again then a procedure called a matrixectomy is required. This is very similar to the above procedure except after the nail margin is removed a chemical or laser is used to “kill” the cells that grow the nail in the deformed area so that they will no longer grow a nail. This again can be a small portion up to the entire nail depending on the shape of the nail and amount of deformity of the nail.
  • You then go home and change the dressing daily until healed.

These procedures are performed in our own office and are very routine.

Enchondromas are not cancerous but there is no reason to suffer needlessly. For more information please contact our office nearest you! You can call us at (405) 947-8041 for Oklahoma City and (580) 237-3338 for Enid, OK.

Written by: Scott Shields, DPM

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