A quick look at a common nail condition you've never heard of
If you've ever had a hangnail, you know how irritating they are. Hangnails can be painful and getting rid of them is an exercise in trying to avoid an infection.
Your feet are more important than you might think. Each foot being a complicated structure made up of 36 joints and over 100 soft tissue structures, there’s plenty of opportunity for something to be awry. In fact, 19% of men and 25% of women experience foot pain some days which prevents them from going about their daily activities.
If you’re wondering what your foot pain could be about, look no further. We’ll explore all the most common foot ailments and what may be done about them.
A bunion is a common condition in which the first metatarsal turns towards its corresponding second toe. This can cause pain and difficulty with wearing shoes, running efficiency (or even walking), if not treated appropriately. This bunion is often sensitive and can lead to difficulty wearing shoes, impaired use when walking and running, and degenerative arthritis. Signs include the characteristic bump with redness, soreness, and stiffness in the big toe joint.
Multiple things can prompt a bunion to form, including tight shoes, genetics, congenital deformity, and inflammatory arthritis. We use X-rays to help determine the severity of the bunion and the best remedy.
There are numerous ways to treat bunions and their accompanying pain. Treatments range from conventional options that involve changing shoe gear, orthotics, and surgical correction. Depending on x-ray findings, different surgical procedures can be performed, including bone shaving, bone cutting, realignment, or even joint fusions.
A bending of the lesser toe joints into a fixed position is known as a hammertoe. These can become ugly and uncomfortable, contributing to corn or callus formation. Hammertoes can be caused by an imbalance in the foot's musculature, where tendons on the bottom overpower those on the top. Sometimes the toe becomes permanently turned in this flexed state, and wearing shoes becomes uncomfortable when the top of the toe rubs against the inside of a closed-toe shoe.
Some people are genetically more likely to develop hammertoes, some are caused by activity and ill-fitting shoe gear, and some people are just born with them.
As with bunions, X-rays are the backbone of properly evaluating hammertoes and determining the best treatment. Treatment starts with learning the actual biomechanical cause of the contracted toe. It ranges from traditional care to alleviate the pain, such as anti-inflammatory medications, shoe gear changes, orthotics, shaving down corns and calluses, to surgical correction.
Surgery is usually very well tolerated and has multiple options depending on the case of hammertoe. These include tendon transfers, toe fusions, or shortening the toe to keep it in a corrected position. The recovery period for a hammertoe correction ordinarily consists of four weeks in a boot.
Metatarsaglia is a pain in the "ball" of your foot where the metatarsal bones are. Pain and inflammation in this area can have several causes. Overuse from physical activity, certain foot types, and poor footwear are common causes.
When increased stress from tight-fitting shoes or a high arched foot occurs in the metatarsal joints, inflammation occurs, known as capsulitis. Capsulitis can also happen in biomechanically unstable feet or where the first metatarsal is shorter than it should be, and the body's weight is not distributed evenly across all metatarsals. Bunions, hammertoes, obesity, and age-related fat pad atrophy are all common causes of metatarsalgia.
Determining the cause is critical to treatment, and x-rays or advanced imaging can help. Making sure your footwear fits properly and has a wider toe box can help, and so can modifying your activities. Orthotics to improve function and offload pressure can also be very effective. Other treatments include cortisone injections and anti-inflammatory medications to relieve pain and inflammation. If the condition is secondary to a deformity such as a bunion, hammertoe, or short 1st metatarsal, corrective surgery is necessary and will relieve pain.
Do your heels or arches hurt? Pain in the arches and heels is one of the most common problems a podiatrist will see. Pain in the heel or along the inside of the foot could be due to Plantar Fasciitis. The plantar fascia is a ligament running from your heel to the base of your toes and supports your foot. If this ligament is tight, it can pull on the heel when you step down, causing inflammation and discomfort.
The typical plantar fascitis patient will describe pain when they step out of bed in the morning, sit down, or stand on their feet during the day. Treatment involves adding a heel lift to shoes, orthotics, anti-inflammatory medicines, and corticosteroid injections. These work together with daily active stretching or physical therapy to resolve plantar fasciitis pain.
Podiatrists treat plantar fascia tears with a walking boot worn for four weeks, followed by physical therapy. Persistent plantar fasciitis, which is rare, can be treated with several surgical methods.
Is there a painful mass or lump on your foot?
If it's on the top of the foot, it may be a ganglion cyst. Ganglion cysts are fluid-filled sacs that form off of the lining of a joint or tendon. Trauma or chronic irritation causes these, causing inflammation, pain, and occasionally numbness. These can be aspirated in a podiatrist's office, and a corticosteroid injection can prevent them from reappearing. Other times your podiatrist can remove them surgically.
If the mass is on the bottom of your foot along your arch, it could be a plantar fibroma. A fibroma is a benign tumor within the plantar fascia ligament, caused by injury or genetics, that causes pain and discomfort when walking or wearing some shoes. To help ease the pain, anti-inflammatory medications and corticosteroid injections, as well as orthotics, are helpful. Some topical medications containing calcium channel blockers have also proven beneficial in some cases.
A boney exostosis could be another cause of a lump on the foot. A boney exostosis is an outgrowth that ordinarily occurs near a joint. These prompt the area to become painful, swollen, and even discolored if footwear causes friction. In some instances, an arthritic joint might be the culprit. Anti-inflammatory medication, corticosteroid injections, orthotics, and surgical removal are all options for treatment.
Stress fractures, also known as hairline fractures, are particularly painful and notoriously challenging to see in X-rays. These fractures are usually from overuse and exhaustion and are very common in athletes. Inflammation and discomfort located in a specific area over the bone can be a sign of stress fracture. Stress fractures are typically treated using a walking boot for six weeks.
Toe fractures and other fracture types have different levels of severity, and this determines treatment. Signs of a fracture are persistent pain and swelling with difficulty or inability to bear weight after an injury. If this happens to you, X-rays are highly recommended to evaluate the damage. Fractures can sometimes be lessened and splinted and sometimes require surgical open reduction with internal fixation. Fortunately, the bone usually takes only 6-8 weeks to heal.
Whether it's a nagging discomfort from walking or standing, don't let your feet keep you from enjoying life. Call us today for an appointment and we'll get them (quite literally!) back up and running again!
