You have had peripheral neurpathy diagnosed, have some numbness and tingling to the feet (especially the great toe) and have started having pain to the nail over the last couple weeks. You have done your research and feel it is an ingrown toenail. But what you don't understand is why the nail hurts if your feet are numb, and is there risks of treating an ingrown toenail in neuropathy?
1. Why does the nail hurt in a numb foot?
You need to understand, first, that neuropathy is often not the absence of nerve function, but a malfunctioning or poor functioning nerve. This may mean you have pain for no reason, increased pain from mild injuries or even absence of pain when it should hurt. We have seen patients with broken bones that don't feel it and simple calluses causing severe pain due to neuropathy. The ingrown nail can often over stimulate the nerve and cause more discomfort than usual. Even with a numb foot or toe the ingrown can be painful.
2. Are there increased risks for treating an ingrown toenail in neuropathy?
Although neuropathy can make the associated pain confusing with an ingrown toenail, there are no increased risks associated with neuropathy to nail treatments. There are, however, increased risks from diabetes or some of the other systemic causes of neuropathy. We recommend you carefully have your nail evaluated by a specialist in foot and ankle health to determine if any additional risks should be considered. We treat ingrown toenails on a regular basis in neuropathy patients without any special considerations. The decreased associated pain will often decrease the associated symptoms of neuropathy.
Ingrown toenails should be treated to reduce infection risk and excess pain even in the patient with peripheral neuropathy. You have pain, why should you live with pain that can be treated?