Flatfoot

Flatfoot is a condition where the arch or instep of the foot collapses and comes in contact with the ground. In some individuals, this arch never develops.   When flat feet persist, the majority are considered variations of normal. Most feet are flexible and an arch appears when the person stands on his or her toes. Stiff, inflexible, or painful flat feet may be associated with other conditions and require attention.

Painful flat feet in children may be caused by a condition called tarsal coalition. In tarsal coalition, two or more of the bones in the foot fuse together, limiting motion and often leading to a flat foot.

Ganglion

A ganglion is a benign fluid-filled mass that typically forms in the soft tissue of the wrist, ankle or top of the foot. It feels like a firm, rubbery lump and is not usually painful unless it grows large enough to rub against the patient’s shoe. There may be a tingling sensation in the toes if the ganglion presses on a nerve in the skin or if the patient taps the lump.

Ganglions occur most often in women aged 25-45. They often form spontaneously (with no underlying cause) when the soft sheath around a tendon or joint swells and fills with mucus, and they can also grow or shrink. Ganglions only require treatment when they cause significant discomfort. Drainage of the fluid through a needle may relieve symptoms, although the ganglion frequently returns. Surgical removal may then be recommended.

Gout

Gout is a type of arthritis characterized by too much uric acid in the blood. Uric acid is a natural waste product of the body that is normally filtered out of the bloodstream by the kidneys and excreted during urination. Patients with gout have an abnormal metabolism that reduces the kidneys’ effectiveness. Uric acid then accumulates in the blood and forms painful crystalline deposits in one or more joints or soft tissues, usually in the feet and legs. The most commonly affected joints are the big toe and knee.

The classic symptoms of gout are swelling, redness, warmth and a stabbing or throbbing pain in the affected joint. Symptoms usually appear suddenly. Acute attacks are treated with anti-inflammatory drugs to reduce swelling and pain. Attacks that recur over time can damage the joint, so patients with the chronic condition will typically be prescribed a medication that reduces uric acid levels in the blood.

Neuroma

A neuroma is a painful swelling of a nerve, usually in the ball or heel of the foot. Symptoms include sporadic pain; burning, tingling or numbness of one or more toes; and a popping sensation when walking. Pain is often soothed by taking weight off the foot or by massaging the area.

In the foot, there are the long bones (metatarsals) and thin nerves running between them. The nerves split in a Y-shape when they reach the toes. If the metatarsals move abnormally, they can pinch the nerve between them, causing inflammation and, eventually, permanent nerve damage. Morton’s Neuroma is the most common of this type and affects the nerve between the third and fourth toes. Neuromas may also occur after a nerve has been injured, either from a traumatic wound or from damage suffered during surgery.

Sesamoditis

Pain in the ball of the foot below the big toe may be caused by sesamoditis, an inflammation of two small bones called sesamoids. Sesamoids are found in many joints in the body. In the big toe, they protect the tendons that pull the toe against the ground and stabilize it when walking. Naturally these two small bones are subjected to great pressure and frequently suffer damage in the form of inflammation or stress fractures, especially from high-impact activities such as running, jumping and ballet dancing and from wearing high-heeled shoes. People with very arched feet are also susceptible to sesamoid injury.

Spurs

A heel bone spur is a bony calcium growth on the bottom of the heel that stretches the nearby muscle and ligaments. Along with a condition called plantar fasciitis, it is the most common cause of heel pain. Bone spurs are a complication of plantar fasciitis that form where the ligament pulls on the heel bone. Spurs don’t usually cause pain themselves, but they are often a good indicator of the severity and age of the underlying problem.

Treatments for heel pain include calf muscle stretching exercises, anti-inflammatory medications, cortisone injections, arch support, orthotic inserts, and surgery.  Risk factors for developing plantar fasciitis and heel spurs include wearing high heels or cowboy boots, exercises that tighten calf muscles, flat feet and very high arches.