Your feet are an amazing combination of bones, muscles, ligaments, tendons
and other soft tissue. They bear the pressure of all the weight of your body.
This stress, combined with a number of other factors like heredity, aging and
even poor fitting shoes, can cause the development of painful foot problems.
To determine the exact nature of your problem, an orthopaedic foot specialist will
conduct a thorough examination of your foot. Once the evaluation is complete, your
doctor will discuss surgical or non-surgical options that may be appropriate for
a number of conditions:
Calluses Callusees, which
typically develop on the ball or heel of the foot, are composed of hardened
patches of dead skin cells. The skin on the sole of the foot is ordinarily about
forty times thicker than skin anywhere else on the body, but a callus can double
this normal thickness. A protective callus layer naturally develops to guard
against excessive pressure and chafing. Calluses can develop from wearing poorly
fitting shoes and walking on hard surfaces. Treatment involves relieving the
pressure on the skin, usually by modifying the shoe. Pads to relieve the bony
pressure are also helpful, but they must be positioned carefully.
After soaking your feet to soften the calluses or after a bath or shower when the skin is softer, a pumice stone or callus file can be used to remove some of the dead
skin and reduce some of the pain and pressure from a thick callus. If conservative measures fail to provide relief, surgery may be necessary to relieve the pressure that causes the callus.
Flatfoot Flatfoot (also
known as pes planus) is a common defect in which there is no arch. Flatfoot may
be hereditary or acquired with diseases of the muscles and nerves. In infants
and toddlers, the longitudinal arch is not developed and flat feet are normal.
The arch develops in childhood, and by adulthood, only one in seven adults has
flat
A physician can make a diagnosis of flatfoot just by examining the foot. Symptomatic flat footedness can be treated. If flat feet cause pain, an orthotic (arch preserving insert in the shoe) may bring relief.
High Arches
High arches (sometimes referred to as claw foot or pes cavus) are a deformity of the
foot marked by high arches. High arches may be associated with clawed or hammer toes. High arches are an abnormal orthopaedic condition and may be associated with a neurological condition. They can be painful because they are usually stiff and place more pressure on the heel and under the toes.
In order to make a conclusive diagnosis, your doctor may order x-rays of the feet and spine, an electromyography, and nerve studies to rule out a neurological condition. Corrective shoes may help to relieve pain and can improve walking. This includes orthopaedic modifications to shoes, such as an arch insert and a support insole. Surgery is sometimes necessary in severe cases.
Ganglion A ganglion is a
benign cystic swelling (often no bigger than the size of a pea) and can be found
anywhere under the skin. A ganglion is essentially harmless and usually
painless. However, if you observe a bump on your foot, seek your doctor's advice
to rule out other causes.
Diagnosis is made through a physical examination. In some cases, other tests or an x-ray are necessary to rule out other problems. In most cases, a ganglion requires no
treatment and has no effect on one's daily activities. If the ganglion is
painful, a doctor may be able to relieve the discomfort. Nonsurgical treatment involves
puncturing and draining the ganglion, while surgery involves the surgical
removal of the lump.
Neuroma A neuroma is a
damaged or injured nerve. The nerves between the second and third or the third
and fourth metatarsal heads are most commonly involved.
Neuroma pain is from pressure on the neuroma and is relieved by rest and pressure
relief. The symptoms are burning, tingling, numbing and/or a 'pins-and-needles'
sensation. Also, the symptoms are usually worse with shoes and made better by removing your shoes and going barefoot.
It is not uncommon for a tight shoe to result in an impinged nerve in the foot.
Therefore, your doctor may suggest shoe pads to help relieve the pain. Early on,
a cortisone injection may be used to reduce swelling and inflammation of the
nerve. If this does not help, surgical treatment may be required. Many patients describe dramatic relief of symptoms immediately after surgery.
Sesamoiditis Sesamoiditis
is an inflammation of the tendons around the small, round bones that lead to the
big toe. Often there is no clear cause, but sesamoid injuries are common among
people who participate in high impact activities, such as dancing, jogging and
aerobics. Rest and reducing stress on the ball of the foot are the first lines
of treatment. A low-heeled shoe with a stiff sole and soft padding inside are
all that is required usually. In severe cases, casting may be required. Surgery
is rarely necessary.
