We had a patient come in to see us recently with the tip of her second toe being red, feeling tender and looking a little swollen. She had experienced ingrown toenails previously, and said it felt a little bit like that. Except this time, she had cut her toenails short a week or so prior – and the area that was painful wasn’t immediately down the side of her nail but above it, where the nail used to be before she cut it.  She wasn’t sure what was going on, if it was an ingrown nail, or if it was something else. We thought we’d share what happened in case you’re also feeling like you’ve got pain towards the top of your toe but your nails are trimmed short and the area of the pain isn’t where you’d expect, so you’re wondering whether it could still be an ingrown toenail or what could be causing your toe pain. The actual toe pictured below (just for reference), about a week after we successfully treated it:

Second toe pain: Our patient’s story

When we examined her toe, it was extremely tender to touch in a particular spot only – and it wasn’t the toenail. (Note: pushing down on the toenail did cause a bit of pain, but only from the way that the pushing affected the painful area at the top of the toe). There was a small indent at the top of the toe where the pain was, and the entire tip of the toe was a little reddened and mildly swollen. Very tender to touch. Examining the part that had indented, we found two things: 

• A small corn in the crease – the skin was harder and firmer than the soft surrounding skin 
• A small piece of the nail that had embedded into the nail crease – the crease created in the skin from the previous length of the toenail before it was trimmed

Understanding how this develops, we could see that the nail must have been rubbing against the skin when it was long for some time, which both produced the corn, and encouraged the edge of the nail to become embedded into the skin. Eventually, a small piece of the embedded nail broke off, and was left behind as it was trimmed.

Instant pain relief from treatment

If there’s anything good to come out of this case, it’s that for this patient, her treatment was quick and effective, with the sharp stabbing pain easily instantly after we removed both the embedded nail spicule and the small corn. This is because the swelling, redness and pain was a direct result of the nail spicule still being left behind, which was then made worse by the corn – so once we could remove both of these, the toe would be able to heal and any swelling and pain would subside. This is a common mistake we see when patients treat their nails at home – they may trim their nails, but forget that while something foreign (and sharp!) is piercing the skin, the wound cannot close and heal. Getting it out can be tricky because the nail spicule can be difficult to see, difficult to remove, and painful when you’re using whatever you have at home to try to help, instead of our fine, specialised podiatric tools. Within 5 minutes, we were able to remove the nail spicule, remove the corn completely, and then dress the toe. Our patient had immediate relief from the sharp stabbing pain, and while some tenderness lingered as there was still a small wound there, this had subsided by the next morning, along with the redness and swelling.

Our podiatrists make treating all sorts of ingrown toenails easy

We wanted to share this because while many ingrown toenails are ‘textbook’ – big toenail, down the side of the toe – as ingrown toenail specialists, we see plenty of ingrown toenails that are atypical, but that are still very effectively and simply treated. We’re equipped with all the right tools to make treatment easy and stress-free, and unless you require ingrown nail surgery, can almost always treat and relieve your pain on the day. (If you require surgery we’ll always book you in for it as quickly as possible!).  Book your appointment with us by calling 09 523 2333 or book online here.