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The response to the question below was authored by Marc Mitnick DPM

Stabbing Toe pain After Toenail Surgery

by Rhonda

I had a partial toenail operation on Aug.2nd. It was doing fine and just a few days ago I have been dealing with some numbness at times in my big toe on the right foot and also at times I have a stabbing sharp pain. The Podiatrist did use a chemical to kill the nail root.This is my second surgery on this same toe. I am concerned why the pain will not completely go away.

Thank you,
Rhonda

ANSWER

Hi Rhonda,

Obviously numbness and pain are two different sensations and I am not quite sure where these symptoms are coming from. Both may occur in an ingrown nail surgery.
My first concern would be a neuritis (numbness) where you had the injection to numb the toe. Sometimes, the needle actually hits the nerve and thus irritates it. If this is the case, in most cases it will eventually subside.
The sensation of pain on the other hand is something else. Yes, you may also have pain from the needle hitting one of the nerves, but pain may also be indicative of a problem in the surgical site itself.
The most common causes of pain could be, 1. not all the nail was removed and there is still some nail irritating the side of the toe. 2. the possibility of a reaction to the chemical that was placed in the nail area to kill the root of the nail. If phenol was used, this chemical kills the root of the nail via a chemical burn and it can hurt in some people. 3. the possibility of an infection, which will usually occur 36-72 hours after the surgery.
You had your surgery approximately two and one half weeks ago and by this time under normal conditions you should no longer have any pain.
My best advice is to call your podiatrist and insist he or she actually look at the toe to make sure there is no problem brewing.

Marc Mitnick DPM
DISCLAIMER:

Comments for Stabbing Toe pain After Toenail Surgery

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Click here to add your own comments

Mar 25, 2020
Rating
starstarstarstarstar 		Problem after toenail removal
by: Pamela

It's over 5 months since I had my big toenail removed. Things were going quite well but the last few weeks the end of my toe looks a bit swollen and feels like there's pins pricking the end when touched. I think the toenail maybe growing back a little too. May have to contact podiatrist again. Frightened it's getting infected again.
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Typically it is not the end of the toe that gets infected unless there was a "cut" in the skin five months ago, that has reopened and reinfected.
Certainly, the best advice I could give you would be to contact your podiatrist and he or she look at it.

Marc Mitnick DPM
Aug 16, 2019
Rating
starstarstarstarstar 		Painful TOE
by: Jackson

Have very Similiar Situation
Been About 6 Months.
No Redness or Swelling..
Went to nearby med Center
And got the Clobetasol.

Still after 4 Days feels like
Something is left in there
When I Press in ag the Tip of my Toe..
I'm Afraid to go back to the
Original Padiatrest due to
The Big Needle...
Thanks for Reading
Jackson
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

I understand the fear of the "big needle", but that is for a minute. The pain you are experiencing is daily. So you have to decide which one you prefer.
Even though, I have not examined you, if the pain is at the tip of the toe, I know at least in my office, you would not need another needle. Two things come to mind; either there is still a piece of nail embedded at the end of the toe, or, there is a callus at the end of the toe from the previous ingrown nail, which would have to be cleaned out. Again, neither would require a needle.

Marc Mitnick DPM
Aug 09, 2018
Rating
starstarstarstarstar 		Topical cortisone suggestion
by: Diane

Thanks for the topical cortisone advice. Whether right or wrong, I’ve been putting triple antibiotic ointment with pain killer in there because it seems to help a bit but podiatrist actually said not to do it too often as it may cause fungal? infection. I’m curious to see what he says about the cortisone cream. This week I’ve noticed slight yellow to brown discoloration under side of nail and wondering if it’s infected (or more debris) cuz pain is increasing. I have another appointment next Tuesday with same podiatrist. If another had been available, it would have been ok but I took the soonest available.
Aug 06, 2018
Rating
starstarstarstarstar 		Toe pain 9 weeks post surgery with phenol
by: Diane

At its worst, toe throbs bad enough to wake me at night and I regularly take Tylenol to kill the pain for awhile. Toe looks normal, no redness or obvious swelling, but does still hurt to gently press corner base of toe. Saw podiatrist at 6 weeks, complaining of pain. He very painfully cleaned the area, saying it had some hard debris. He also said lack of swelling or redness indicates no infection. Otherwise, he said toe looked good and he didn’t know what else to do. Felt better for 2 days and then, and still, more pain. Sometimes, the pain is so minimal that I am just vaguely aware of it. This latest bout of increased throbbing pain was precipitated by a very gentle nail trim. Also, swimming in a chlorinated pool or even just getting it wet causes increased pain. I read that cortisone can be injected into the toe to relieve pain. Is this true? Aside from seeing a different podiatrist, any other suggestions aside from the obvious: waiting it out? Thanks for any help!
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

I find it interesting that after he "cleaned" out the area of necrotic tissue (hard debris) the toe felt better for two days, but then returned. That would lead me to believe that there may be more necrotic build up in the toe.

This can happen with phenol procedures as phenol destroys the root of the nail via a chemical burn, and if you have ever burned yourself, you know that burns have a tendency to drain for a while.

This is not a situation for a cortisone injection, but topical cortisone cream applied deep into the area could help reduce the inflammation and thus your pain.

If you trust this podiatrist, go back and let him see if there is more build up and then ask for a prescription for cortisone cream.

If you have lost trust, then see another podiatrist.

Marc Mitnick DPM
Apr 11, 2018
Rating
starstarstarstarstar 		Toe numbness
by: Tosha

Can I possibly have a malpractice case due to nerve damage?
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

I am sure there is some lawyer out there who would make a case for you, but in most cases the nerve is damaged by the injecting needle actually hitting the nerve.
The standard of care is to insert the needle blindly so this does happen from time to time.
The good news assuming it was from the needle hitting the nerve, is that over time your symptoms should improve.

Marc Mitnick DPM
Nov 12, 2017
Rating
starstarstarstarstar 		2 months post surgery pain
by: Mary

I had a part of my toenail removed from it being i grown in Aug 31st. I have been back to my podiatrist twice due to pain. The last time I went the pain had subsided st that appt. And doctor said toe looked great. It is now Nov 12th and the throbbing pain is excruciating. It is. It a 24/7 pain but it is every day at least 3-4 times and it is severe. I can’t keep throwing away money at the doctor’s office to hear nothing is wrong. My nail is becoming white in general edges and appears to be peeling towards the bottom. I often wrap it with gauze when wearing shoes to prevent rubbing and to give it support. Doctor said the nail is still a little loose on the side. Should I still be having such pain over 2 months post surgery??
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

No, you should not be having pain two months down the road. I obviously am only guessing here since I cannot examine you, but the fact that the remaining nail is white and peeling leads me to believe he may have used too much medication to destroy the growth plate of the nail that was removed.
Why not see another podiatrist in your area? The toe may not look so great to him.

Marc Mitnick DPM
Jul 30, 2017
Rating
starstarstarstarstar 		Nerve pain
by: Anonymous

I had surgery to remove ingrown toenails a year ago and my toes hurt so bad. I feel nerve damage and my nails are bumpy and very ugly and crooked! I regret having this procedure done!
Jan 17, 2017
Rating
starstarstarstarstar 		Pain!
by: Sarah

I have same problem but it hasn't gone away in a year! It's always in horrible pain-hurts to wear shoes, but no redness, swelling, dis coloring, etc.

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anonymous



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San Diego, CA



Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY



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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown
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Canada
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Wisconsin
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North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

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Florida
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New Jersey


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a mom

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