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About Common Ball of Foot Conditions and Injuries

Neuroma



Morton's neuroma is an enlarged nerve that usually occurs between the third and fourth toes. 


Symptoms:

The most common symptom is pain in this area.  It can be sharp or dull, and is worsened by wearing shoes and by walking. Pain usually is less severe when the foot is not bearing weight.


Causes:

May be tight shoes, high heels, and flat feet.

Treatment:

Initial treatment consists of padding and taping to disperse weight away from the neuroma. If the patient has flat feet, an arch support is incorporated. The patient is instructed to wear shoes with wide toe boxes and avoid shoes with high heels. An injection of local anesthetic to relieve pain and a corticosteroid to reduce inflammation may be administered. The patient is advised to return in a week or two to monitor progress. If the pain has been relieved, the neuroma is probably small and caused by the structure of the patient's foot and the type of shoes the patient wears. It can be relieved by a custom-fitted orthotic that helps maintain the foot in a better position.  However, if the pain continues, then surgery may be required to remove the neuroma.  


Metatarsalgia

The metatarsal bones are the long bones of the feet.  They are located between the bones that form the ankle (tarsal bones) and the bones of the toes (phalanges).  Metatarsalgia is pain in the long bones of the feet, especially located at the heads (ball of the foot), of these bones.


Cause:

Metatarsalgia typically occurs from doing too much of a weight-bearing activity such as running, jumping, or walking.  It may occur if you start wearing a new type of shoes, especially high-heeled shoes.  In some people, some metatarsals point further down than in the others, making these bones more likely to hurt.


Symptoms:

You have pain and tenderness in the middle of the foot, especially over the bones at the ball of the foot. 

Treatment:

You may be treated with an anti-inflammatory medication.  Temporary padding may to put underneath the tender metatarsal, followed by custom-made arch supports (orthotics) to prevent in the future.

While you are recovering from your injury, you will need to change your sport or activity.  For example, you may need to swim or bicycle instead of run or walk.

 

PlantarFlexed Metatarsal  

Prominent area on ball of the foot just behind the toes. One or more metatarsal bones is lower than the rest


Cause: 
 May be inherited or due to increased weight or activity

Symptoms: Pain in ball of foot-with or without a callus under the plantarflexed metatarsal

Treatment: Orthotics, rest, oral anti-inflammatories.  Steroid injections and/or physical therapy. Occasional surgical treatment


Gout
Uric acid in joint caused by too much protein in the diet. Example: meat, sardines. Certain high blood pressure medications. Kidney disease

Symptoms:
Hot, very painful joint-usually at the base of the big toe- but can also affect the ankle or knee and the elbow

Treatment:
Change diet, drink lots & lots of water. Avoid alcohol. Have your doctor evaluate you for possible meds and or treatment (we offer immediate pain relief treatments)


Capsulitis

Inflammation of a capsule (joint)

Cause:

Overwork or strain of any joint-including sprains (partial tears). Certain medications and or joint diseases-such as rheumatoid or osteo arthritis

Symptoms:

Stiffness in the morning or after a period of inactivity. Tightness & soreness of joint or instability (excess movement) of joint.

Treatment:

Protect joint.  RICE (rest, ice, compression, elevation) treatment for the first 2-3 days after injury-then you may apply heat for soreness. Oral anti-inflammatories such as Advil or Tylenol for one to two weeks. Physical therapy  Biomechanical  analysis and/or computerized orthotics. Brace or surgery for unstable or badly sprained joint.  Early treatment prevents arthritis of the joint.


Myositis

Inflammation of muscle tissue

Symptoms:

Stiffness in the morning or after a period of inactivity. Tightness & soreness of muscle

Cause:

Overwork or strain of any muscle. Direct physical damage. Certain medications and or diseases (chronic fatigue syndrome, rheumatoid arthritis)

Treatment:

Stop or modify the activity that is causing the problem. RICE (rest, ice, compression, elevation) treatment for the first 2-3 days after injury-then you may apply heat for soreness. Oral anti-inflammatories such as Advil or Tylenol for one to two weeks. Physical therapy.  Biomechanical analysis and/or computerized orthotics. Special stretching and or muscle activation techniques.


Warts
Verrucae are benign intraepidermal, highly vascular growths occurring on the hands and feet as well as other parts of the body.
Type found on the foot is a plantar wart.

Cause:
Human Papilloma Virus which enters the skin (epidermis) after injury to the skin (bruise, splinter, etc.)

Treatment:
Don’t risk “bathroom surgery” or use over the counter acids. The podiatrist can dissolve warts painlessly with topical acid treatments or remove them surgically. 

 
Fungus
Fungus infections of the foot and nail spread in warm, dark and moist areas. “Athlete’s foot” makes skin itchy and scaly, nails thick and white.

Treatment:
Your podiatrist may prescribe medication or recommend nail surgery.

Calluses and Corns

Underlying bone problems can cause excessive irritation. Where shoes repeatedly rub, dead skin cells pile up, creating calluses on the bottom of the foot and corns on the toes. 

Treatment: Dissolving corns or cutting out calluses at home is dangerous. Your podiatrist can trim or protect them if they become painful. They usually grow back unless the underlying problem is corrected surgically.  Cause:  Callus is friction and pressure upon the epidermis related to some biomechanical problem or improper shoes.
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The definitions and treatments listed above are for informational purposes only and should not be considered diagnosis of your particular problem. 

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