The most common symptom of a subungual hematoma is severe pain at the nail bed. The area under the nail is restricted, and as the blood builds up, the pressure increases, causing throbbing pain. A blackish discoloration will develop under the nail in the days following the injury, and the nail may start to lift from the nail bed. A rich blood supply is delivered to the nail bed and its high density of nerves — this is why subungual hematomas are so painful. The nail is firmly attached to the tip of the digit, and there is little fatty tissue to absorb the increasing blood. The bleeding rapidly places pressure on the nerve endings, resulting in the intense and throbbing pain.
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