Pain Under the Nail: Causes and When to Seek Medical Help - Family Medicine

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Pain in the nail bed of the middle finger?


Hello, doctor.
Symptoms: There are red spots under the nail of my left middle finger, and I have been experiencing a persistent tingling sensation, especially during winter.
Recently, I have also been feeling sharp pain in my fingers.
Where should I seek medical attention for this condition? Thank you.

Miss Yang, 50~59 year old female. Ask Date: 2012/04/10

Dr. Liao Yaopan reply Family Medicine


Hello, based on your description, it is still recommended that you consult a physician in person for a more accurate understanding of your condition.
You may consider first consulting your family doctor.
Changhua Hospital cares about you.

Reply Date: 2012/04/10

More Info


Pain under the nail can be a concerning symptom, and it's important to understand the potential causes and when to seek medical help. Based on your description of experiencing a red spot under the nail of your left middle finger, along with persistent stabbing pain and occasional finger spasms, there are several possible explanations for your symptoms.


Possible Causes
1. Subungual Hematoma: This is a common condition where blood collects under the nail due to trauma or injury. It can cause significant pain and may appear as a red or dark spot under the nail. If the hematoma is large, it may require drainage to relieve pressure.

2. Nail Fungus (Onychomycosis): Fungal infections can cause discoloration, pain, and changes in the texture of the nail. This is more common in individuals with compromised immune systems or poor circulation.

3. Ingrown Nail: If the nail is growing into the surrounding skin, it can cause pain, redness, and swelling. This condition often requires medical intervention to relieve pain and prevent infection.

4. Psoriasis or Other Skin Conditions: Psoriasis can affect the nails, leading to pitting, discoloration, and pain. Other skin conditions like eczema or dermatitis may also cause similar symptoms.

5. Nail Trauma: Repeated trauma to the nail, such as from typing or using tools, can lead to pain and changes in the nail bed.

6. Peripheral Neuropathy: Conditions that affect nerve function, such as diabetes or vitamin deficiencies, can cause pain and abnormal sensations in the fingers.

7. Raynaud's Phenomenon: This condition causes blood vessels in the fingers to constrict excessively in response to cold or stress, leading to pain and color changes in the nails.


When to Seek Medical Help
You should seek medical attention if:
- The pain is severe and persistent, affecting your daily activities.

- You notice significant swelling, redness, or warmth around the nail, which could indicate an infection.

- The red spot under the nail is growing or changing in appearance.

- You experience symptoms of systemic illness, such as fever or chills.

- You have a history of diabetes or other conditions that could complicate nail health.


Recommended Medical Specialists
For your symptoms, it would be advisable to consult a dermatologist or a primary care physician. A dermatologist specializes in skin, hair, and nail conditions and can provide a thorough examination and appropriate treatment options. If there is a suspicion of an underlying systemic issue, your primary care physician can help coordinate further evaluations or referrals to specialists, such as a rheumatologist if autoimmune conditions are suspected.


Conclusion
In summary, while pain under the nail can arise from various causes, it is essential to monitor your symptoms closely. Given the chronic nature of your pain and the presence of a red spot, seeking medical advice is prudent. Early intervention can help prevent complications and ensure appropriate treatment. Remember to provide your healthcare provider with a detailed history of your symptoms, any recent injuries, and any other relevant medical history to facilitate an accurate diagnosis and treatment plan.

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