Play podiatrist for me: big toe nails ache

[NerdGjerd]

Hello, I would like to hear from those who have had to deal with this issue. Has anyone? The toenails on both of my big toes hurt just enough to be annoying (but NOT while I am walking.) I have not seen this issue on the forum, my searches always find the blisters and black toenail and losing toenail posts. I assume when walking long distances that feet will be tired and achy for a while, but just the tops of the big toes? And for days?

I am seeing a podiatrist, but the progress is slow so far. My feet actually feel great when walking, and they feel fine right after my walk. The time frame when I notice the ache is a couple hours later, and it lasts a day or two after a walk. I am wearing a shoe known for a wide toe box, and it's 1.5 sizes bigger than my normal size, and otherwise feels great.

Here's my theory, which is probably wrong. Maybe my big toes are tall? So the tops of my nails contact the top (not the front) of the toe box. But I cannot feel the toes touching anything while I am walking. Any thoughts on that theory?

I don't think it's typical "Black Toenail" which I learned here can be caused by repeated banging of toe tip onto front of shoe often when going downhill.

Things that do not help:
- It is not an ingrown toenail
- It is not These Shoes in particular. This same type of pain is worse when I try other shoes. But I would be interested in trying shoes with a "tall" and wide toe box if that's a thing.
- I've tried the stock insoles, and the podiatrists brand of decent non-custom orthotics
- I have tried the Heal Lock lacing method, and that did not help.
- I usually walk with liner injinji toe socks, and another sock. I have tried just one sock. All are the same results, except Maybe a bit worse if the socks are thick. But it's hard to tell since they usually hurt each time. Maybe I'll try some more training walks with just one thin sock again because too much sock in the toe nail area seems like a good diagnosis.
- I usually apply aquaphor to my toes and feet (about the same as vasaline) but I've tried without, and it doesn't make the ache any better.
- It's not a lack of nail trimming, they are nice and trimmed.

I've thinking of carving out much of the big toe cushion area of an orthotic, to see if that creates more toe height room.

When it first started happening, one of the nails got injured a little bit, never black and blue, but separated partially just about 1/4 of the toe nail on upper corner. After that, a small wide bump formed in the nail as it grew out. Podiatrist jumped on that thinking it was fungal. But I am having doubts that is related. I am applying anti fungal coating to them twice a day, but that is not making a difference. Plus my nails look fine, they do not look like disgusting fungal infected nails. Podiatrist is new, he has a partner who I have seen years ago, with more experience. I will try to get her to take a look as well.

More details on me. I'm 6' 200Lb, 59yr, in OK shape. In the last year I have increased my walking to many walks per week. Sometimes 12 miles (20km) walks, but i am not yet in good Camino fitness level of 15+ miles per day repeatedly, I hope to get to that level soon. Anyone else experience this type of pain?

 

[Dani7]

I would ask my physician to take an xray of my feet. Just to rule out osteoarthritis (which often starts with the big toes). Inflammation can settle in more post exercise than during. Just my thoughts.

 

[bestfootforward]

I wonder whether your toenails might be 'involuted' which is very different to ingrown. This causes pain and pressure which starts under the toe nail and presents pretty much the way you've described.....I only say this because I've experienced it. Ask your podiatrist if they're familiar with involuted nails. If he's fairly new to the game he may not be aware. If they're involuted, the good news is it's fixable. If that's not it, @Dani7 may be onto something.