I had one quack unsuccessfully remove the nail with no pain-killer while I was in college. The jerk kept telling me that I was just being a baby and that it did not hurt that much (proving that not only was he an asshole, he had never had it done to himself).
When his flubbed job came back to haunt me in my early 20s, the next doctor took the time to fill my toe with novocaine (or something) that wound up hurting more than the extraction. He was surprised that I could feel anything after the stuff he had injected, (he started with a medium sized syringe and when I could still tell him where he was touching the toe while he blocked my vision, he got a second syringe that was huge). On the other hand, since he was trying to do it right and was paying attention to what I told him, I put up with the aggravation of the actual surgery.
In both cases, once the surgery was done, I did not suffer for days and days–probably a bit sore for a day, but nothing like what it had been before the operation. (In each case, my toe was swollen and infected before the operation.)
The first attempt was the most pain I have ever felt in my life. I have a hard time watching movies where they talk about bamboo under the nails.
I had both big toes done several times when I was a kid, with general anaesthetic every time. After having each foot done two or three times, the doctor killed the sides of the root on both. I have a little spur of nail angling up on one, but it’s no problem as long as I keep it trimmed. I don’t recall any significant pain after any of the surgeries.
My index toenail fell off for no good reason about 10 years ago. Now it grows kind of slanted and very slowly. I probably have to cut it about twice a year.