While the most common descriptors of ingrown toenails from our patients include painful, frustrating, uncomfortable, annoying, excruciating, can’t-wear-shoes-anymore and can’t-sleep-at-night, we recently had a patient call in to book an appointment because he’d had an ingrown toenail for a couple of weeks now, and alongside some pain and discomfort, it was feeling quite numb.
Meeting him at the clinic, we discussed that he’d tried looking up online whether numbness, particularly around one side of his big toe, was normal or if it could be a sign of something more sinister – with no luck at all from Dr. Google. So today, our podiatrists at the Auckland Ingrown Toenail Clinic thought we’d answer this question for anyone else stuck in the same boat: Is numbness normal in ingrown toenails?
No, we don’t usually expect your toe to feel numb
First thing’s first: in our experience, numbness is not on the ‘typical’ or ‘expected’ list for common symptoms associated with ingrown toenails. We expect feelings of pain, swelling, redness, bleeding, and even clear/yellow discharge if an infection is present, because given that a piece of nail is currently piercing into your skin, these are all fairly normal responses from your body.
Your body wants to stimulate quick healing and direct your immune cells to the site to fight off infection or prevent it – and hence your toe swells and becomes red with the increased blood flow. The action of the nail piercing the skin is painful, and any additional pressure to the area from shoes or bed sheets will exacerbate the pain. This is all expected.
Numbness, on the other hand, is a ‘neural symptom’, meaning that it starts from a problem or interruption in one of the nerves in your foot, leg or back that then, instead of delivering clear messages of sensation or pain to your brain, provides a numb feeling. Is the cause of the nerve interruption having your nail pierce the skin? It’s unlikely – especially given that the problem is at the tip of the toe, and if your whole toe is numb, we’d expect the nerve interruption/damage to occur further up the toe or foot.
But, it’s definitely possible
With that said, it could be that your toe is so intensely swollen – and you’ll know if this is happening to you – that all the extra fluid and pressure in your toe is pressing on a nerve and creating those neural symptoms, which can include numbness, pins and needles, burning, tingling and more. So we’re not ruling it out completely or saying that it doesn’t happen, it’s just not the ‘norm’. If this is the case, the numbness would be very localised to the tip of that toe – and wouldn’t extend far down the toe, the foot, or to the other toes. That’s just due to the way our nerves work and give sensation to different areas of the feet.
It could be the symptoms of two problems, simultaneously
It may well be that the numbness you’re feeling is a symptom of another problem, that just so happens to be affecting your problematic ingrown toe, as well as potentially other parts of your feet or legs. There are a number of causes of numbness in the toes and feet, including:
- Diabetes – this is the most common cause, and arises because, over time, diabetes causes damage to our nerves, which leads to a problem called peripheral neuropathy – which causes numbness and other neural symptoms in our feet. It can also ultimately lead to the complete absence of sensation, so you’ve got to be very careful
- Arthritis – whether it’s rheumatoid arthritis, osteoarthritis or gout, if you’ve got arthritis in the joints of your feet, particularly at your big toe, and particularly if you’ve got some notable swelling happening, then this may be compressing the nerves in your feet and resulting in numbness in the big toe
- A new injury – following similar principles to arthritis, if you’ve recently injured your foot, whether it’s a muscle, tissue or bone, and you’ve still got some new or lingering swelling, it may be compressing a nerve and causing your numbness. Or the injury itself may have damaged a nerve, resulting in the same symptoms
- It’s winter, and the blood vessels in your feet have constricted – a less common but possible cause is vasoconstriction, meaning the narrowing of the blood vessels, in your feet. Cold is a big cause of this, as our body wants to minimise heat loss and so our blood vessels constrict. The result is decreased blood flow, especially at the tips of the toes, which leads to problems like Raynaud’s, frostbite and more. If this is the case, you’ll also likely notice your feet feel quite cold, and may be white and patchy
- Circulation problems – following on from the above, you may just have circulation problems, and the same process is happening, except that the weather isn’t the cause, but it’s the changes or damage to the blood vessels creating the problem
- It’s your bunion (if you have one) – finally, it could be related to the joint changes you’re experiencing in the big toe joint at the ball of the foot directly related to your bunion
It’s a clear indicator that you need to treat your ingrown toenail – as your risks increase
Whatever the reason, one thing that’s definitely for sure is that you need to have your ingrown toenail treated ASAP. We rely on our body’s ability to feel to inform us of so much – including when things are going wrong, which we feel as pain. If the numbness is taking over to the point where instead of pain, we feel numb, then our body isn’t alerted to the problems we may be experiencing – including ingrown toenails. This puts you at risk of your nail significantly worsening, developing an infection, or even a secondary infection (which is when it gets pretty bad!), and you being unable to detect it due to the numbness. When you don’t detect it, you don’t know that you need to treat it – and so the problem worsens.
It’s a vicious and dangerous cycle, and the long story short is that if you have an ingrown toenail and you’re getting any numbness, reduce your risks and have your ingrown toenail treated ASAP. Most ingrown toenails do not get better on their own, so for most people, they are just delaying the inevitable.
Uncertain as to what’s happening with your toe?
We’re here to help. We’re Auckland’s leading ingrown toenail experts, and offer a number of solutions for painful, frustrating and numb ingrown toenails, including options to fix the problem permanently using a minor surgical procedure.
For any questions, or to book an appointment with our team, give us a call on 09 523 2333 or book online. We’re located within the One Health Clinic in Remuera, inside Perform Podiatry.