Introduction to Subungual Exostosis (Bone Spur Under Toenail)

Subungual exostosis, also known as a bone spur beneath the toenail, is a condition that develops when a bony growth forms under the toenail. This condition can cause significant discomfort, and in some cases, impair the normal function of the toenail. Understanding the causes, symptoms, treatment options, and prevention strategies for subungual exostosis is crucial for those dealing with this issue. This article aims to provide a comprehensive overview of the condition and offer practical advice for managing and preventing it.

Causes of Subungual Exostosis

Subungual exostosis often develops due to repeated trauma or injury to the toenail bed or the bone beneath it. This pressure and irritation over time can lead to the formation of a bony protrusion. Key factors contributing to the development of subungual exostosis include:

• Repetitive Microtrauma: Activities such as running, hiking, or wearing ill-fitting shoes can repeatedly impact the toenail, causing damage to the nail bed and bone beneath it, which triggers the formation of a bone spur.

• Previous Injury: A past injury to the toe, such as stubbing the toe or dropping a heavy object, can increase the risk of developing subungual exostosis.

• Genetic Predisposition: Some individuals may have a genetic tendency toward developing bone spurs or bony growths in the feet, making them more susceptible to this condition.

Symptoms of Subungual Exostosis

Subungual exostosis is often characterized by the following symptoms:

• Pain or Discomfort: Pain in the affected toenail is common, particularly when pressure is applied, such as when walking or wearing shoes.

• Swelling: The bone spur beneath the toenail can cause swelling and inflammation in the surrounding tissues, leading to redness and tenderness.

• Changes in Toenail Appearance: The toenail may become distorted, lifted, or discolored as the bone spur grows beneath it.

Diagnosis of Subungual Exostosis

A podiatrist or healthcare professional typically diagnoses subungual exostosis through a physical examination and evaluation of symptoms. To confirm the presence of a bone spur and assess its size and extent, diagnostic imaging such as X-rays may be performed.

Treatment Options for Subungual Exostosis

Treatment for subungual exostosis depends on the severity of symptoms and the impact on daily activities. Some common treatment options include:

• Conservative Measures: For mild cases, wearing wider shoes, cushioning the affected toe, and avoiding activities that worsen the symptoms may help alleviate pain and discomfort.

• Trimming the Toenail: In some cases, trimming or thinning the toenail can help relieve pressure on the bone spur and reduce pain.

• Surgical Removal: For more severe cases or when conservative measures fail, surgical removal of the bone spur may be necessary. During the procedure, the podiatrist removes the bony growth from beneath the toenail to relieve symptoms and restore normal toenail function.

Prevention Strategies

While subungual exostosis may not always be preventable, there are steps individuals can take to reduce their risk:

• Wear Proper Footwear: Choose shoes that fit properly and provide adequate support and cushioning to help prevent trauma to the toenail bed and underlying bone.

• Practice Good Foot Hygiene: Regularly wash your feet, trim your toenails straight across, and avoid wearing tight footwear to maintain foot health and prevent subungual exostosis.

• Seek Prompt Treatment: If you experience symptoms like pain, swelling, or changes in toenail appearance, consult a podiatrist or healthcare professional for evaluation and timely treatment.

Conclusion

Subungual exostosis, or a bone spur under the toenail, results from repeated trauma or injury to the toenail and underlying bone. Symptoms include pain, swelling, and changes in toenail appearance. Diagnosis is made through a physical examination and imaging tests. Treatment options range from conservative measures and toenail trimming to surgical removal of the bone spur. Preventive strategies include proper footwear, good foot hygiene, and seeking prompt medical attention for symptoms. With appropriate care, subungual exostosis can be effectively managed to maintain foot health.

For more information, check out WebMD's Guide on Foot Health.

Disclaimer

The information on this website is provided for educational and informational purposes only and is not medical advice. Always consult with a licensed medical provider and follow their recommendations regardless of what you read on this website. If you think you are having a medical emergency, dial 911 or go to the nearest emergency room. Links to other third-party websites are provided for your convenience only. If you decide to access any of the third-party websites, you do so entirely at your own risk and subject to the terms of use for those websites.

Who we are: For trusted podiatric care in Orlando, Lake Mary, Altamonte Springs, Longwood, Apopka, turn to Dr. Carli Hoover and Dr. Sean Griffin at Central Florida Foot and Ankle Institute - a physician owned-operated group. From sports injuries to general foot health, our team offers specialized treatments tailored to your needs. Contact us now at 407-307-0006 to schedule your consultation and take the first step toward healthier feet!