If you are experiencing pain at the center of your toenail or your toenail is lifting off of the nail bed or it has become thick, then you may be suffering from a bone spur beneath the toenail. These types of spurs are called subungual exostosis. These are usually benign bone growths on the top of the bone at the tip of the toe where the nail is. If the spur becomes large enough, it can push on the nail plate and cause pain. It can become especially painful with tight shoes. To diagnose the bone spur an X-Ray is obtained to look for the overgrowth of bone. Sometimes the bone growth is cartilaginous and will not show up on an X-Ray and an MRI is ordered.
Conservative treatment involves padding the area, wearing shoes with taller toe box and keeping the nail cut short and thin. If this does not help, the bone spur can be surgically removed with a small incision at the tip of the toe. This is performed outpatient at a surgery center. The portion of bone will then be sent to pathology to ensure that it is benign as there are some types of bone tumors in the foot that are cancerous. At Advanced Foot & Ankle Center, our providers have experience dealing with these issues and are available to evaluate you for this or any other foot/ankle condition that you may have. Please call 972-542-2155 for an appointment