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The foot is a complex system of 38 bones connected by numerous joints, muscles, tendons, and ligaments. It bears the full weight of the body and is susceptible to many internal and external stresses that can cause pain, inflammation, injury, or disease. Some very common problems we take care of include:
A bunion is typically caused by an abnormal position of the metatarsal bone (bone behind the big toe) which progresses over time and frequently causes inflammation and thickening of a small sac of fluid in the joint of the big toe. The skin over the joint may become swollen and tender, the joint may become enlarged, and the big toe may become displaced. Bunions may just appear, but they can also be caused by genetics, foot position, improper footwear or arthritis.
Treatment for a bunion(s) includes wearing shoes that conform to the shape of the foot and do not cause pressure areas. Several types of surgery are also available that may relieve pain and improve the appearance of the foot.
Hammertoes are a deformity that causes the toe to have a permanent (sideways – consider removing) bend in the middle joint , actually giving it the appearance of a hammer. Biomechanical deformity cause the contracture and tight shoes often aggravate the toe, which results in pain over the prominent bony areas on the top of the toe and at the end of the toe.
Treatment for hammertoes may involve any/all of the following:
- modifying shoes to accommodate the deformed toe
- pads positioned carefully over the bony prominence
- insert modifications to reposition the toe and decrease pain
- surgery to remove a bony prominence
Plantar warts occur on the sole of the foot as a result of an infection or a specific virus. They look like calluses, and are like other warts, but grow inward because of weight placed on them. They may cause severe pain when walking.
Treatment for plantar warts may involve any/all of the following:
- applications of salicylic acid to soften the overlying callus and expose the virus
- application of cantharadin
- injection of medication into the warts
- freezing the warts with liquid nitrogen
Corns and Calluses
Corns and calluses – very rarely a serious problem - are thick layers of skin. They are caused by repeated pressure or friction at the spot where the corn or callus develops. They frequently occur when bones of the foot press against the shoe or when two bones press together. Common sites for corns and calluses are on the big toe and the fifth toe, and soft corns can occur between the toes. Common sites for calluses are underneath the ends of the foot bones (metatarsals).
Treatment for corns and calluses may involve any/all of the following:
- modifying shoes to relieve pressure on the skin
- pads positioned carefully over the corn or callus
- surgery to rebalance the foot or remove a bony prominence causing the corn or callus
Heel pain is a common condition that often begins without noticeable injury. Pain felt under the heel, usually while standing or walking, is most commonly caused by inflammation of the connective tissue on the sole of the foot where it attaches to the heel bone.
Most of the time, this condition will heal without treatment, although medication to reduce swelling of the soft tissues and shoe inserts may relieve the pressure and pain. Steroid injections or walking casts may be used for cases that do not properly heal. Occasionally surgery is recommended.
Heel pain is most often the result of overuse. Your heel may become tender or swollen from:
- Shoes with poor support or shock absorption
- Running too often or on hard surfaces, like concrete
- Tightness in your calf muscle or the Achilles tendon
- Sudden inward or outward turning of your heel
- Landing hard or awkwardly on the heel
A neuroma, often referred to as Morton’s neuroma, is a pinched nerve that usually causes pain between the third and fourth toes, but may involve other areas of the foot as well. When foot bones are squeezed together, the nerve responds by forming a neuroma, which is really a build-up of extra tissue around the nerve.
A neuroma is very painful and can make walking difficult because of the numbing or tingling that comes from it. Often patients refer to a “pebble” being felt beneath their foot. The exact cause of a neuroma is unknown, but a high arch, toe deformity, tight calves, or flat foot as well as improper footwear could be the reason. Because symptoms often get worse over time, it is best to see a specialist when you develop symptoms. A full history, exam and possibly other tests may be needed for a correct diagnosis.
Treatment may involve wearing wider shoes or taking oral anti-inflammatory medications, to decrease the swelling around the nerve. A metatarsal pad or custom orthotics on the sole of the foot to spread the bones may also help. In more extreme cases, cortisone or sclerosing agent injected around the nerve or surgery to remove the neuroma may be used to correct the problem.
Our team takes the time to understand your problem and comes up with the best treatment option based on your goals.