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Patient Presented With A Painful Ingrown Toenail

Posted By On 01 Sep 2015
Foot Specialist

Patient presented with a painful ingrown toenail – By Kiran Dave, D.Ch, Chiropodist / Foot Specialist

There are many unnecessary and painful conditions related to the great toe or lesser toes, which can be avoided with some simple sound advice, professional examination and early treatment. I would like to demonstrate with a case of a painful ingrown toenail that I saw in my Mississauga clinic recently.

A patient in the early 20’s presented with an acute, painful, inflamed right toenail, with a purulent discharge. The patient complained that she could not wear a closed shoe or sleep at night as the bed sheets caused her discomfort on the right toe. On examination, the patient had a typical ingrown toenail on the medial sulci of the right toe, with an infection.

What was the cause of the ingrown toenail?

In this situation, there was a number of reasons. However these are common causes for the condition.

  1. Improper toenail cutting. Toenails were cut too short and down the sides.
  2. The right great toe was in an abnormal triggered configuration, creating pressure on the sides of the nail.
  3. The footwear was too narrow and shallow, which further aggravated the pressure on the toenail.
  4. The quality of the nail plate was thin and very flexible, thereby more prone to be directed under pressure into the side of the toe space.
  5. There was as added structural problem, with the medial toe pressure from the patient pronating.
  6.  Patient was uninformed and did not know what to do so she kept digging into the sides, further perpetrating the problem.

What was the solution to the ingrown toenail?

The solution; Patient was seen for professional advice and treatment of the toenail and foot.

What was the treatment for the ingrown toenail?

  1. As the condition was too far developed, a partial nail avulsion surgery was scheduled.
  2. The surgical procedure involved the administration of local anesthesia with a safe freezing agent. The offending nail was surgically removed partially.
  3. The nail matrix (roots) was phenolized to prevent further growth and prevent reoccurrence.
  4. Post-surgical dressing and advice was given.
  5. Patient returned to work the next day.
  6. Patient was monitored until complete healing, over several weeks.
  7. Education regarding proper nail cut.
  8. Footwear advise

If you encounter any challenges to your toenail or toes, please schedule an appointment earlier rather than later.

Also, check out Kiran’s blog on why cutting your nails too short is NOT a good idea and can lead to other painful toenail problems.

Kiran Dave, D.Ch, Chiropodist / Foot Specialist in Mississauga at Erin Mills Optimum Health

Chiropodist Foot Care Specialist


Ingrown Toenail Pain – Do you need Chiropody Treatment?


There is no greater pain than an ingrown toenail.
Some will describe the pain as being comparable to a bad tooth ache and it is usually unbearable.

Our chiropodist is ready to meet your ingrown toenail and help eliminate the pain and resolve the situation as quickly as possible.

Through careful examination of potential problems that may have given rise to this problem, he will help educate and allow you to make an informed decision on what may be the most appropriate course of action for you.

How are ingrown toenails diagnosed?

Ingrown toenails are technically diagnosed when a sharp piece of toenail is penetrating the flesh of the skin and causing an infection or/and an inflammatory response. It will appear very red, hot to the touch and painful, even without touching it sometimes. Commonly, patients will describe the bed sheets at night time being bothersome.

Most of the patients will attempt to cut the offending piece of nail, and sometimes find temporary relief. Some will visit their family doctor who may attempt to do the same. However, our chiropodist advises against these practices, as it will usually worsen the condition and set up a scenario where the underlying problem is allowed to create more progressive problems. This can make further treatment more complicated, delaying adequate resolution.
Besides, it is better to have a specialist such as our chiropodist to have a better look and administer proper and safe treatment, after considering all factors, such as medical conditions, drugs history, usual activity involved and occupational stress.

We see more unnecessary ingrown nail infections after a home treatment than any other nail condition. Some are not even ingrown toenails, but another condition called involuted nails.

What will our chiropodist do for you?

This question depends on what stage of the condition is reached and what the proper diagnosis is.

  • Is it infected or just inflamed?
  • How long has the patient experienced pain and what has been done previously?
  • Are there other aggravating factors that can be simply eliminated for more comfort?
  • Are there biomechanical factors that are contributing to the condition such as a hyperextended hallux?
  • Footwear history is considered as is the medical and drugs history.

Once a clear pictured is formed, the chiropodist will do what is required to resolve the pain as quickly as is possible. This could be simple conservative treatment or it could require surgical removal of the offending nail for good.

Our goal is to get you back to your naturally healthy self from the feet up!  Contact us for help.

Kiran Dave. D.Ch.
Chiropodist / Foot Specialist in Mississauga at Erin Mills Optimum Health

Kiran Dave Chiropodist Foot Specialist Education Treatment Foot Related Functions



Want to learn more from our foot guy Kiran? Read his blog on the common foot issue of Bunions here or connect with him in person in Mississauga.

This information and linked articles should be taken for informational purposes only and should not be relied upon for health care advice. Enjoy these testimonials. However, a result for one patient may not be typical of all patients. Our aim is to help you have an excellent experience at our Mississauga office and to help you reach your health goals.

  • Posted on 17-10-2017 by erinmills

    No, our Chiropodist does not use a toenail brace for ingrown toenails. He uses other methods depending on the presentation of the particular case. Thanks for your question.

  • Posted on 10-10-2017 by Connie Timleck

    Do you use the toe nail brace for ingrown toenail

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