Pain when pressing on the toenail is most commonly caused by an ingrown toenail, which occurs when the side of the nail grows into the surrounding skin, or by an infection of the skin folds known as paronychia. These conditions typically create tenderness, redness, and swelling that becomes sharp and painful when touched or squeezed.
If the toe has recently been injured or subjected to tight shoes, the pain may be due to a subungual hematoma, a collection of blood trapped beneath the nail that causes intense pressure and throbbing. In rarer cases, exquisite pain located at a specific point under the nail could indicate a glomus tumor or a benign bony growth called a subungual exostosis.
Chronic pain and inflammation at the base of the nail, especially after trauma, may be signs of retronychia, a condition where the nail grows backward into the cuticle. This is frequently misdiagnosed as a simple infection but often requires different management.
It is important to consult a podiatrist or dermatologist if the pain persists or if there are signs of infection such as pus, warmth, or severe redness. Patients should avoid self-medication or attempting to cut the nail out at home, as improper handling can worsen the infection or lead to complications.