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I have had to do this on my toenail a couple of times. Just heat up a paperclipper's end with a flame and stick it through the nail while it's still red hot. It's actually quite painless and takes away the pain that is caused by the elevated pressure under the nail.

Had a dog bite me on the tip of a finger, same thing happened.

Clinic doc heated up a paperclip with a bic lighter and melted through the nail to make the hole.

Never went back to that sawbones again. A little too ghetto for me...

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Had this done to my big toe nail when I was about 13 or 14. Some buddies and I saved up all our monies and rented out an ice rink to play some hockey together. They day before, I was cleaning my room so my parents would let me go. My t.v. was on a rolling stand, and I pulled it out so I could vacuum behind it, but I noticed too late it had three wheels as opposed to the four it was supposed to have. So as I pulled it forward, it tipped over where that missing front wheel was, and slid off the stand. I tried to catch it by the sides, but it was too heavy and slipped through my hands. Quick thinking lad I was, I tried instinctually to catch it with my foot (I didn't want to break my t.v.!), but only managed to catch the very corner of it as it smashed down onto my toe. Luckily my doc used these little threaded needles to make the three holes to relieve the pressure, not the bic and clip method. And indeed it didn't hurt at all, but my step-dad passed out watching them do it. Needless to say the resulting monstrosity didn't fit into an ice skate, and my buddies took my share of the rent and had a good ol' time. A little while later the entire toe nail fell off, and it's never looked the same since.