Pain big toe , chronic type 2 diabetic.

[nikas]

GP diagnosed fungal infection and now on systemic antifungal treatment but, pain persists and affecting quality

Almost six months pain in big toe.Sugar levels controlled. No ulceration or other contributing pathology.
Walking difficult and need pain killers everyday

 

[Inka]

Is this you @nikas or someone you’re caring for? Has the nail become thickened and if so, is it that causing the pain?

 

[everydayupsanddowns]

Sorry to hear about the painful toe @nikas

Hope it’s OK - I’ve tweaked your thread to reduce the length of the title.

Where is the infection? Is it between the toes like athletes foot? Or in the nail?

The level of pain you are describing sounds very unpleasant, and debilitating

 

[nikas]

It’s mainly the tip . It hurts when he wears shoes so I guess the pressure intensifies the pain.The fungal infection is in the nail.

 

[nikas]

Is this you @nikas or someone you’re caring for? Has the nail become thickened and if so, is it that causing the pain?

I’m his wife. I’m a doctor,a pathologist.I thought initially it was a diabetic vascular/ neuropathy but the GP said it was a fungal infection.I know pain can accompany fungal infection but hmmm it’s an unusual presentation.

 

[nikas]

The nail is brittle as far as I can make out .

 

[Leadinglights]

The nail is brittle as far as I can make out .

I had had a fungal infection in my big toe nail for years and had painted different treatments on but the nail became partly detached so my GP referred me to podiatry, they assessed it and suggested removing the nail and treating to prevent regrowth but by the time I got the appointment they could see new nail growing underneath which looked healthy so just snipped away the loose nail. They advised using Vicks on the nails to treat the fungal infection and that seems to have 'cured' it. The toe was sore during that time, sensitive to pressure.
He could see a private podiatrist to get advise, they charge around £60 for the first assessment.

 

[nikas]

He did see a podiatrist who said there was nothing wrong with the nail …I couldn’t believe he d missed it ..

 

[Drummer]

I've not bought new footwear for years, decided to get new boots and they are labelled as the correct size, but they were smaller than they should have been - I wonder if the pain could be from new shoes 'resized' smaller - maybe not the reason for the sensitivity, but compression making it worse.

I have been a size 5 or 38 in modern terms since I was at school, but the 38s I sent for do not fit and even 39s are a bit tight. The 38s from years back are absolutely fine. I tried on the shoes I wore to get married in after delving into the back of the wardrobe (hello 1979) and they still fit

 

[Inka]

It’s mainly the tip . It hurts when he wears shoes so I guess the pressure intensifies the pain.The fungal infection is in the nail.

Could he try wearing open-toed shoes? Maybe freeing the toe tip from pressure will relieve the pain. It would also allow more air to get to it.

 

[nikas]

Yes I agree 100% I did tell him that and he’s now wearing sandals. Will see how it goes
Ta
Nithya

 

[indio02]

Almost six months pain in big toe.

My first thought when you say pain in big toe was Gout.

 

[everydayupsanddowns]

The nail is brittle as far as I can make out .

I suppose if the nail has become enlarged, brittle, and is splitting, it may be splitting back into non-fungal nail whihc could cause pain.

I had a fungal nail a few years back, dab-on treatments never did much, but the oral meds sorted it right out. Though my Dr was a bit reluctant to prescribe them as they are pretty full-on I believe.

 

[nikas]

Gout was my differential diagnosis. It’s not that thank god. He is on systemic medication for fungal treatment so
It’s great getting all this information from all of you.
Thanks to all of you .

 

[nikas]

Ps so let’s see how it goes….sorry didn’t complete the sentence