toe pain

i had my foot stepped on repetitively, and also wore poorly fitted shoes to a music concert, where I was on my feet dancing and walking around for about 10 hours. The big toe is still sore (5 days later), and completely grey/black under the nail and there is a very swollen, red, painful lump at the base of the toe nail on the right side. It is very painful to walk, and agony if it is stepped on or bumped at all. Some sites and a friend has mentioned popping the potential blood blister under the toe to release the enormous amount of pressure, but my big toe nail is very thick, and the thought horrifies me. Should I just pop it to release the blood etc or wait for it to heal.

RESPONSE
Hi,
Besides the pain that you are experiencing, there is also the possibility that the nail area has become infected.
Yes, the discoloration under the nail is blood and under most circumstances it should be drained. The problem here is that you should not be attempting this yourself, for two reasons.
One, as you point out the nail is too thick. How were you going to go about puncturing the nail? Two, five days have passed and there is a good chance the blood has started to dry out, meaning even if you could puncture the nail, the blood might not flow out and drain.
Because there is a possibility of infection based on how red the toe looks beyond the nail itself, i would think the best advice I could give you would be to see a foot specialist as they would be the best one to treat this problem.
Since the blood has probably dried out somewhat and since the nail is too thick to pierce a sharp object through, the nail will probably have to be removed. This is not a serious procedure, but more than likely will require the toe being "put to sleep".
Having said that, sometimes I find that if there has been enough bleeding under the nail, the nail will begin to lift off from the nail bed. In these instances I can usually cut away enough of the nail, without pain, in an effort to free up the blood underneath. (keep in mind, because of the trauma and the bleeding, you are probably going to lose this nail anyway, a new nail will grow out after that).
As stated previously, there is also the possibility of an infection and of course that cannot be treated by you. It will require medical attention.
So, find the services of a good foot specialist and your toe should heal uneventfully.

Marc Mitnick DPM
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