Common Foot Problems to Watch for in Your FeetBy Michael Nirenberg, DPM Eighty percent of people, at some point in their lives, have a foot problem that requires medical care. However, many people let their problems persist and worsen untreated. Here is a list of the most common foot problems I see in my practice that you can watch for to ensure the health of your feet.
Heel PainHeels get a bad rap. The dictionary defines a heel as a dishonorable person, and the term "Achilles' heel" refers to a fatal weakness. The reality is our heels are quite strong, though no other part of our foot malfunctions more. Heel pain is the number one reason people come see me. Heel pain can be very complicated and may have a variety of causes, including a stress fracture, pinched nerve, bone cyst, or tumor. Most patients with heel pain believe they have a heel spur. This may be part of the problem, but the most common cause of heel pain-whether or not a heel spur is also present-is inflammation of the largest ligament in our foot, the plantar fascia. In doctor-speak this problem is called plantar fasciitis. Treatments for plantar fasciitis range from custom-made arch supports (called orthotics), to simple stretching exercises, to the revolutionary, high-tech shockwave treatment.
Nerve ProblemsBurning, numbness, tingling, or shooting pain in our feet or ankles often means something is wrong with a nerve. Nerve problems are common in our feet, so if you have one don't get nervous. Most of the time, the treatment is relatively simple. The main nerve problems I see are:
• Morton's Neuroma
Not to be confused with Morton's Steakhouse-which may cause a full stomach-Morton's neuroma causes cramping, tingling (a feeling of pins and needles), burning, or shooting pain in the toes or ball of your foot. A neuroma is a painful growth on a nerve that forms when the nerve becomes irritated. Treatment for neuromas consists of using a special arch support, called an orthotic, and sometimes injections are needed. Surgery is rarely necessary.
• Tarsal Tunnel Syndrome
Almost everyone has heard of carpal tunnel syndrome in our hands, but few people realize the same problem occurs in our feet. Tarsal tunnel syndrome may cause burning, tingling, shooting pain, or a cramping sensation in our foot. The good news is that there is a light at the end of this tunnel. Tarsal tunnel syndrome is often easily treated with orthotics, injections or a short, outpatient procedure.
Neuropathy literally means a "disease of the nerves," and it affects millions of people each year. Persons with neuropathy often experience loss of sensation, burning, tingling, or shooting pain. The number one body part affected by neuropathy is the feet. Persons with diabetes are those most afflicted with neuropathy, but it also occurs in people with thyroid problems, vitamin deficiencies, alcoholism, and some types of arthritis. Neuropathy has many treatment options and some people might opt for a new, somewhat controversial, procedure that involves surgically freeing up the nerves to restore normal sensation to their feet.
Arthritis of the Foot and AnkleDegenerative joint disease, osteoarthritis, or just plain old "Arthur" is a deterioration of the joints between our bones. When Arthur visits people's feet or ankles, many believe they just have to live with it. This is far from the truth. The reality is podiatrists have many techniques to alleviate arthritis, including a high-tech, tiny arthroscopic camera that can remove arthritis from sore ankles.
Nail ProblemsI am not talking about rusty nails on your garage floor, but ingrown toenails and fungal toenails. Ingrown toenails occur when the edge of the nail grows deep into the flesh of the toe. These are painful and can become infected. Fortunately, a brief, in-office technique can alleviate ingrown toenails, often permanently. Fungal toenails are another story, and usually require a long course of medication.
BunionsThese are protrusions of bone or bumps that form on the inside of the foot at the joint at the base of the big toe. If you wear ill-fitting shoes, don't blame them for bunions. Blame your parents. Bunions are inherited. However, poor footwear can contribute the formation of a bunion. Numerous conservative treatments, such as trying wider shoes or foot soaks, can alleviate painful bunions, though getting rid of them requires a short, outpatient surgical procedure.
Other Big Toe Problems
• Hallux Rigidus
With hallux rigidus the big toe may look normal; however the inside of the joint at the base of the big toe is deteriorated and painful. Sometimes the big toe won't bend. Like bunions, simple treatments can lessen the pain, but in on some cases surgery is necessary.
Known as the "rich man's disease," gout doesn't just affect the rich. Gout is a type of arthritis that most often occurs in the joint at the base of the great toe, causing redness, swelling, and pain. Some patients say the pain was so severe they couldn't stand the bed sheet resting on their toe. Other patients describe less intense symptoms.
Gout occurs when too much uric acid is present in our body. Uric acid is a natural chemical that our bodies manufacture, and we ingest in certain foods, like pork, beer, or liver. Treatment consists of altering the patient's diet to limit the amount of uric acid they ingest, and if that isn't enough, medication is prescribed.
• Corns and Callouses
Corns have nothing to do with plants that grow ears. Painful corns (and callouses) are a build-up of hard, dead skin that often occurs due to an abnormal bony prominence or a bone out of position.
Corns occur on toes and callouses are found on the bottom of the foot. Contracted toes (hammertoes) cause corns to form, and callouses form when a bone or bones are out of position. Treatment of a corn or callous depends on what is wrong with the bone underneath them.