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TYPICAL FOOT PROBLEMS

Following are twelve of the most common foot problems. Find out about the symptoms and suggested treatments. Be sure to see your doctor if you suspect you have a problem.

The Foot Health Foundation of America, a national health initiative, lists many of the following common foot ailments. Others are listed by the American Association of Orthopaedic Surgeons. Also included below are brief descriptions and suggested treatments of each condition. As always, any chronic pain, swelling, or other problems of the feet or body should be professionally evaluated.

Achilles tendinitis

  • Irritation and inflammation of the tendon that attaches to the back of the heel bone.
  • Can be caused by improper warm up or over training.
  • Can be treated with ice, rest, aspirin, or anti-inflammatory medications.
  • Should be evaluated by your healthcare professional.

Bunions

  • Misaligned big toe joints that can become swollen and tender. Painful enlargement at the joint of big toe.
  • First joint of the big toe may slant outward. The second joint may slant toward the other toes.
  • Condition tends to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe.
  • Surgery is frequently recommended to correct the problem.
  • After age 65, there is a 200% greater risk in developing a bunion.

Corns/calluses

  • Areas of thick, dead layers of skin. (Serves as padding over skin tissue under excessive pressure: a reaction to foot abuse and stress.)
  • Usually results from repeated wearing of tight, ill-fitting shoes (high heels, ill-fitting shoes, etc). Most common on big toe and fifth toe. Calluses also are found underneath ends of foot bones. Soft corns may also develop between the toes.
  • May be caused by obesity, problems with walking motion, flat feet, loss of fat pad on foot bottom, bony prominences, and other problems.
  • See your foot doctor for a thorough examination of your feet.
  • Get both feet properly fitted for shoes. Wear thick socks for sports activities and recreational walking. Pads and orthotics may be prescribed. Surgery is the last resort.
  • Avoid temptation to remove corns and calluses with razors/knives.

Hammertoe

  • A condition, usually stemming from muscle imbalance, in which the toe is bent in a claw-like position.
  • Most frequently occurs with the second toe, often when a bunion slants the big toe toward and under it.
  • Selecting shoes and socks that do not cramp the toes will help alleviate aggravation.
  • Shoe inserts or pads may help. If no improvement, surgical treatment many be necessary.

Heel pain/spurs

  • Growths of bone on the underside, forepart of the heel bone.
  • Can be inflammation of connective tissue on the sole of the foot.
  • Occurs when the plantar tendon pulls at its attachment to the heel bone. Can later calcify to form a spur.
  • Strain to the ligament can be reduced with proper warm-up and the use of appropriate athletic shoes.
  • May improve spontaneously. Medication and shoe inserts may be helpful.
  • Steroid injections and walking casts may be prescribed if pain continues. Surgery is only recommended in the most troublesome cases.

Ingrown toenails

  • Nails whose corners or sides dig painfully into the skin.
  • Frequently caused by improper nail trimming. May also be caused by shoe pressure, injury, fungus infection, heredity and/or poor foot structure.
  • Can be prevented by trimming toenails straight across, selecting proper shoe style and size, and paying attention to foot pain.
  • Because of shoe styles, women are 50% more likely than men to have ingrown toenails.

Neuromas

  • Enlarged benign growths of nerves, most common between the third and fourth toes.
  • Caused by tissue rubbing against and irritating the nerves, or "pinched nerve." Ill-fitting shoes (usually tight) or abnormal bone structure also can create the condition.
  • Pain may radiate from tissue buildup through toes.
  • Treatments include shoe inserts (orthotics) and/or cortisone injections, but surgical removal of the growth is sometimes necessary.

Plantar fasciitis (See Heel pain)

  • Pain on the bottom of the feet -- very irritating, but rarely serious.
  • Commonly traced to an inflammation (of the plantar fascia, the tissue that connects your heel bone and toes)
  • A podiatric physician can evaluate, and may prescribe customized shoe inserts to help alleviate the pain. According to the Mayo Clinic, there is no quick cure to this condition. It can take 6 months or longer before your heel is back to normal." Custom orthotic devises, ultrasound, corticoseroids, or surgery may be recommended.

Plantar warts

  • Occur on sole of foot and may look like calluses. Grows inward. May be one or many.
  • Caused from an infection of a virus.
  • May cause severe pain when walking.
  • Difficult to treat, but often improves with salicylic acid (available at drug stores without prescription).
  • Other treatments by physicians may include injecting with medication, freezing with liquid nitrogen, and on very rare occasions, surgery.

Sesamoiditis

  • Problems with two small bones (the sesamoids, known as the "ball bearings of the foot") found beneath the first metatarsal bones.
  • May inflame or rupture under the stress of exercise.
  • Can be relieved with proper shoe selection and orthotics.

Shin splints

  • Pain to either side of the leg bone.
  • Caused by muscle or tendon inflammation.
  • Commonly related to collapsing arch (excessive foot pronation), but may be related to muscle imbalance in the leg.
  • Proper stretching and corrective shoe inserts can help prevent shin splints.

Stress fractures (different from "complete" fractures)

  • Incomplete cracks in bone.
  • Caused by overuse.
  • Heal quickly with complete rest. Extra padding in shoes helps prevent them.
  • Left untreated, they may become complete fractures, which require casting and immobilization.

Fungal infections

Most fungi are harmless until they penetrate the skin. A fungus can invade through minor cuts, causing the nail to separate from the bed. The fungus can cause the nail to thicken and become yellow or brownish. Pressure from a thickened nail or the buildup of debris may cause the toe to become painful. Treatment can consist of filing the nail plate down with a surgical burr, in addition to oral or topical medications.

Fungal foot problems are painful infections. A synthetic antifungal agent such as Penlac® (ciclopirox) inhibits the growth of dermatophytes, a type of fungus that grow on the skin, hair, and nails. These infected nails can become white, thick, and brittle causing pain in people when they walk or do other simple activities

Sources:
American Academy of Orthopaedic Surgeons (AAOS)
Center for Podiatric Information
Foot Health Foundation of America, a National Health Initiative of the American
Podiatric Medical Association 1-800-615-0807
The Foot and Ankle Institute of Utah (www.feetnet.com)
FDA Consumer Magazine March-April 2000

Want to learn more about conditions of the feet? Then check out these articles in the Foot Problems Forum:
Foot Problems as Symptoms and Warning Signs
Foot Care Providers
Preventing Foot Problems
Young Feet, Old Feet
Glossary of Terms
Foot Health
Anatomy of Your Feet

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