Toenail Surgery

Toenail surgery initial consultation costs £50 and it is required prior to the actual toenail surgery procedure where a neurological and vascular assessment will be carried out, medical history will be taken, and this will indicate whether toenail surgery is appropriate and can be safely carried out.

Then, if happy to proceed and there are no contra indications with the procedure, consent will be signed and the toenail surgery procedure including aftercare will be fully explained and written advice will also be issued.


The nail surgery procedure costs (£350 – one toe), (£500 – two toes) and lasts approximately 1 hour.

You will be advised to start carrying out 15-minute salty water baths twice a day and redressing of the toe that has been operated on starting the following day of the procedure. Salty water baths will continue for the following 3 weeks and then will stop.

However, redressing will continue daily until the area is completely healed.

When a chemical (phenol) is applied to prevent partial or complete nail regrowth it takes approximately 4-8 weeks approximately for the area to heal completely. However, this may depend on compliance with the re-dressings, footwear choice, activity level and infection post operatively.

Redressing appointments (3 x 15 minute) are included in the price to ensure the operated side is healing efficiently. Also, dressings (1 box of sterile gauze and 1 box of dry dressings) and a seal tight (waterproof protector for showers) will be issued and will also be included in the nail surgery procedure price.

If the nail surgery procedure is carried out to 2 toes, then 2 of the above will be issued (2 boxes of sterile gauze and 2 boxes of dry dressings) and 2 seal tights (waterproof protector for showers).

The first redressing appointment in the clinic will take place 1 week after the nail surgery procedure, and the following 2 remaining re-dressing appointments will then be arranged accordingly.

Nail surgery is the partial or total removal of a damaged, deformed or ingrowing toenail. A local anaesthetic is used so that you will feel no pain during the procedure. After the partial or total removal of the nail, a chemical (phenol) may be applied to the exposed nail bed to prevent regrowth by destroying the nail matrix and prevent regrowth.

  • Recurrent ingrowing toenails
  • Thickened nails that can become problematic over time and difficult to manage
  • Involuted symptomatic toenails difficult to manage
  • Less discomfort in the toe and pain resolution
  • Easier footwear choice and more comfortable walking
  • Prevent recurrence of the condition and recurrent infection episodes
  • Do not drink any alcohol or have any local anaesthetic 24 hours prior to the procedure.
  • Arrange to have this day off work and everything to be organised in the house for you, as you will have to be home after with your foot elevated until the next day and avoid standing and walking around as much as possible.
  • Have nail varnish removed from the toenail.
  • Have your breakfast or lunch as normal and make sure you are well hydrated.
  • Arrange transport in advance for the day to take you home.

We strongly advise that you do not drive on the day after your nail surgery, because of the numbness, the risk of bleeding and trauma.  Doing so may invalidate your car insurance and it also increase the risks of an accident as your toe will still be numb.

You should not travel on public transport on the day of the procedure, as there is an increased risk of bleeding and to prevent injury.

We advise you to sit on the back seat of the car, with the foot that nail surgery was performed elevated and your seat belt on.

Normal comfortable clothes. Making sure that trousers can roll back above the ankle on the day. Bring open sandals or open slippers to accommodate a big dressing on the toe.

The procedure will be performed in a clinical room by our Specialist Podiatrist and normally takes less than 1 hour.

A local anaesthetic will be injected into both sides of the base of the symptomatic toe and wait for about 10 minutes until the toe is numb. The sensation of both touch and pressure are not affected, this is normal. The local anaesthetic may cause some discomfort when being injected into the toe.

Once the toe has been checked that is fully anaesthetised, a tourniquet (tight band) will be applied to the toe to prevent bleeding during the procedure.

After the surgery, the tourniquet will be removed, the toe will be checked for return of your blood supply to the toe and a sterile dressing will be applied.

You will then remain for a short period of time in the clinic with your foot up and ensure you are well to leave the clinic.

Injecting the local anaesthetic into the toe can be uncomfortable. However, once the toe is fully anaesthetised approximately 10 minutes later only touch and pressure is felt but no pain.

Some people experience pain, whilst others report no discomfort.

Yes, you can take painkillers if required, but avoid Aspirin products as they encourage bleeding.

There is no reason why you should not return to your routine daily activities including work the following day, providing you wear roomy footwear as advised and do not carry out activities which will aggravate the operated toe and disturb the healing process.

Only if you want to. However, we generally advice you not to and you will lie flat whilst the procedure is carried out.

There may be some bleeding after the procedure but not usually during.

Nail surgery is generally a safe, simple and effective method of removing a symptomatic nail partially or totally.

  • Delayed healing/prolonged weeping
  • Infection-during the post-operative period
  • Adverse reaction to phenol (phenol flare) occurs in less than 1% of cases
  • Regrowth of the nail may occur, the national regrowth rate is 3%
  • Anaphylaxis- a hypersensitivity/allergic reaction to the local anaesthetic (adrenaline/EpiPen) is held within the premises to reverse this if required)
  • Complex Regional Pain Syndrome

Contra-indication list:

  • Peripheral Vascular disease
  • Bleeding disorders such as Von Willebrand disease, Haemophilia
  • Pregnancy
  • Recent history of Myocardial infarction or DVT
  • Poorly controlled autoimmune disorders
  • Heavy smoking

Cautionary list:

  • Autoimmune disorders such as Diabetes
  • Anticoagulant therapy
  • Steroids
  • Beta blockers
  • Renal and hepatic impairment

We will invoice your medical insurance company directly, so you do not need to worry. If you do not have insurance and are a self-payer, we ask for payment by credit/debit card.

Yes, this is highly recommended to prevent complications and ensure you will gain the best possible outcome out of the nail surgery procedure.

Unfortunately, we do not carry out nail surgery on children.

Unfortunately, not at present. Currently we do only have a male Podiatrist.

Our Podiatrist is highly experienced in treating patients with damaged, deformed or ingrowing toenails, that are symptomatic and difficult to manage. The treatment you receive will be tailored to you, and your condition. This ensures that the resulting treatment plan is most likely to achieve the results you need. Our aftercare service ensures that we will provide help and assistance should this be necessary.

A Biomechanical examination at London Back Pain Clinic is carried out by our expert Podiatrist, in order to identify and treat any foot pathologies that can result from foot, leg and posture misalignment, compensation and poor mechanics and may cause injury and pain.

Being able to stand and mobilise effectively is vital in order to carry out our daily activities. Having muscles and joints unable to provide sufficient force and movement due to weakness, imbalance or pain can lead to Biomechanical abnormalities.

When a problem develops with our feet and legs, the way we stand and walk alters which can further cause painful symptoms in several parts of our body. This occurs due to potential compensations and adjustments of different body structures that can become overloaded and finally result in repetitive stress, inflammation and injury.

At London Back Pain Clinic we are experts at utilising our Biomechanical assessment/gait analysis examination in order to formulate individually tailored treatment plans including physical therapies, stretching and strengthening exercise plans and an orthotic prescription if required to treat present painful symptoms and future prevention or further deterioration of current existing pathologies.

Orthotics are special shoe inserts that a Podiatrist prescribes and can be either off the shelf or custom-made specifically for you from a precise imprint taken of your feet. The aim is to correct any foot abnormalities, improve function and help restore normal balance and alignment of your body.

A Podiatrist may prescribe orthotics to treat foot, leg, or back problems. This can be part of a comprehensive treatment plan to address various symptoms, usually having to do with pain and discomfort of the feet and legs. Orthotics can be used in conjunction with other treatments such as physical therapy and exercise plans, which may help a person avoid more invasive treatments.

Some of the aims of orthotic prescription include:

  • Correcting foot deformities
  • Providing better support and encouraging better foot and ankle functioning
  • Offloading or cushioning painful areas
  • Reducing the risk of further injuries 
  • Treating current injury/inflammation

Orthotics are suitable for people of all ages and are tailor-made to the individual’s needs and requirements depending on their level and type of daily activities.

Depending on the individual this will vary from going to work, a long walk, going for a jog or even competing as an elite athlete.

  • Arthritis
  • Symptomatic foot pronation or supination (Foot rolling inwards or outwards)
  • Development of bunions (HAV) and generally symptoms with the 1st toe joint (Metatarsophalangeal joint)
  • Plantar fasciitis & heel spurs
  • Sesamoiditis, Bursitis, Capsulitis, Synovitis, Neuroma
  • Achilles tendonitis, Posterior tibial tendonitis/dysfunction
  • Knee, hip and back pain
  • Strains, sprains & tendinopathies
  • Shin Splints

Normal comfortable clothes in order to examine the range of motion of joints during the consultation. Ideally, a pair of shorts or leggings can make the examination easier.

A Biomechanical Examination/ Gait Analysis, which is a prerequisite for obtaining orthotics, takes approximately 60 minutes. At the end of this session, off the shelf orthotics can be purchased on spot, alternatively, measurements for a custom-made orthotics are taken.

Then a 15 minute follow up appointment will be arranged that will be included in the orthotics initial price paid (One for the fitting once the bespoke orthotics are ready and then 8 weeks later to review them and progress).

Assessment does not usually hurt, but please discuss this with your Podiatrist should you have any concerns over any discomfort.

Orthotics do not usually hurt, however when initially prescribed can feel uncomfortable to wear. The wearing time should increase daily but very gradually in order to avoid any pain symptoms and allow the body to adapt to the change smoothly.

You are more than welcome to bring a friend or family member to the sessions.

We will invoice your medical insurance company directly, so you do not need to worry. If you do not have insurance and are a self-payer, we ask for payment by credit/debit card.

Insurance companies do not cover orthotic fees and therefore, as you are a self-payer in this case payment can be carried out by credit/debit card.

Yes, you can for the Biomechanical assessment/Gait analysis. We are recognised by all the major health insurance providers. However, as mentioned above insurance companies do not cover the fee for orthotics.

Unfortunately, we do not perform a Biomechanical assessment/Gait analysis or prescribe orthotics to children. It is advised to see a Paediatric Podiatrist in this case.

Unfortunately, we only have a male Podiatrist at present.

Our Podiatrist is highly experienced in managing patients with lower leg, foot and ankle problems. The treatment you receive will be tailored to you, and your condition. This ensures that the resulting treatment plan is most likely to achieve the results you need. In addition, our access to a multi-disciplinary team including Physiotherapists, Chiropractors, specialised spinal surgeons and pain specialists, means that should you need further treatment, this can be organised in a timely and seamless manner.

Our aftercare service ensures that we will provide help and assistance should this be necessary.