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Pain in the toenail due to incomplete healing of the tissues - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User :   In March 2010, I began having occasional pain at the end of my right great toenail, not at the base but a few millimeters from the the interior edge of the nail end. The pain in not on the surface but feels deep in my toe. This continued to occur over the summer. There was no redness or swelling at anytime. The pain began to occur more frequently and intensely in the fall. Anytime I bumped my toe I experienced excruciating pain. I believed I had an ingrown nail. I visited a podiatrist in the orthopedic group I use. After an examination and the doctor ablated the side of the nail. After a couple of days, the area was red and oozing fluid. A return to the podiatrist resulted in an antibiotic prescription and instruction that the skin next to the nail would take time to heal. After the ten day dose, the inflammation subsided, yet the pain did not. The pain was the same as prior to the original visit. After six weeks, I returned to the podiatrist asking if I might have a spicule. He said he believed all the nail was removed. He then used silver nitrate on the tissue exposed by the ablation. He said the skin had granulated and that this should resolve the pain. Unfortunately, now six weeks later, the pain is still present when my toe is bumped, or pressed at the same spot, the end of the nail corner. Is this common? Do I have a spicule? Could there be some other problem associated with my toe? Thank you for your time and consideration of my ailment.
Doctor :   Hi,
Doctor :   Dr here
User :   Hello, thank you for your time
Doctor :   Let me read your query for few minutes to be able to have a good discussion here.
User :   Okay
Doctor :   ok,
Doctor :   i consider the granulation tissue has not evolved completely
User :   What does that mean, evolved?
Doctor :   the blood vessels are not entangled with good amount of connective tissue to form a hard mass
User :   The tissue growing where the nail bed bed once was is tough, irregular. The vertical edge of the nail is tender, but the most painful area is a spot at the end and a couple of millimeters away of the nail. This is the site of the original pain.
Doctor :   that is where the granulation tissue has to form a scar after laying up connective tissue
User :   So the tissue growing to replace the nail bed area will take some time. I understand. I am still concerned that the site and pain are the same as prior to the surgery.
User :   Is there anything else I can do to assist the evolution of the tissue?
Doctor :   yes, the cut ends are the places where the granulation tissue takes origin
User :   Will soaking it stimulate the blood vessels?
Doctor :   yes,
Doctor :   thanks for consulting me , kindly provide your feedback
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