Hi @cdc43, Welcome to Connect. This discussion hasn't been active lately but several members in the discussion may have missed your post. I'm tagging them here to see if they can share any more information with you.

@kenc mentioned the pain under the big toe nail turned out to be caused by a fungus in the post above yours.
@jeanniem had an appointment setup with a podiatrist and may be able to share the cause of the pain.
@miker8888 recommend seeing a Board Certified Podiatric Surgeon. I had major pain in big toe due to calcification of joint. Surgery helped tremendously.

Have you seen a doctor or podiatrist?

I never did find out what it was. I did end up having my toenail removed. Apparently I had walked too much?? I have super high arches (apparently common in genetic neuropathies) and some muscle atrophy in under the toes and in my ankle. This likely contributes to my gate being a bit off. This last year, I saw a new neurologist who put me on a low dose of Baclofen. She felt like some of the twitching I have might be connected to central nervous system involvement.

All that to say, my toe no longer experiences the sharp pains like I did a year ago. Is it due to the toenail removal? the Baclofen? or a coincidence? I honestly don't know. I am sorry to not be more help. Keep advocating for yourself. In the world of western medicine, symptoms that don't lead to immediate debilitating or life threatening illness are often dismissed. I always try to find a doctor who is curious by nature. I find it helps. 🙂