A neuroma is a thickening of nerve tissue and can develop throughout the body.  In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes.  The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.

Neuromas can be caused by anything that causes compression or irritation of the nerve.  A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes.  Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas.  Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.

Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up.  Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot.  An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.

Treatment for Morton’s neuroma can vary between patients and the severity of the condition.  For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed.  Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition.  The severity of your condition will determine the procedure performed and the length of recovery afterwards.

Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.

Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.

The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.

Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.

Flatfoot is a foot disorder that is not as straightforward as many people believe.  Various types of flatfoot exist, each with their own varying deformities and symptoms.  The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot.  Other signs of flatfoot include:

• “Toe drift,” or the pointing outward of the toes and the front part of the foot
• The tilting outward of the heel and the tilting inward of the ankle
• The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
• Hammertoes
• Bunions

One of the most common types of flatfoot is flexible flatfoot.  This variation usually starts in childhood and progresses as one ages into adulthood.  Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing.  When not standing, the arch returns.  Symptoms of flexible flatfoot include:

• Pain located in the heel, arch, ankle, or along the outside of the foot
• Overpronation, or an ankle that rolls in
• Shin splint, or pain along the shin bone
• General foot aches or fatigue
• Pain located in the lower back, hip, or knee

Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit.  X-rays may be taken to define the severity and help determine the treatment option best for your condition.  Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices.  If nonsurgical methods prove ineffective, surgery may be considered.  Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans.  Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases.  Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.

Complications of the disease may lead to several foot and ankle-related conditions.  The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat.  Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.

To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure.  Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation.  The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.

Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding.  These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form.  Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet.  The resulting deformity is a foot that is flattened and wider in appearance.

To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes.  Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces.  In more serious cases, surgery may be considered to treat more developed deformities.  Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

Bunions are large bony bumps at the base of the big toe. Medically known as hallux valgus, a bunion is a misalignment of the metatarsophalangeal joint, or big toe joint. The misalignment will generally worsen with time if left untreated.

The exact cause of bunions is unknown, with genetics seen as a potential cause. High heels and poorly-fitted footwear, rheumatoid arthritis, and heredity all seem to be potential factors behind the exacerbation of bunions. Women have been found to be more likely to develop bunions in comparison to men.

Bunions do not always produce symptoms. The best way to tell is if the big toe is pushing up against the next toe and there is a large protrusion at the base of the big toe. You may or may not feel pain. Redness, swelling, and restricted movement of the big toe may be present as well.

Podiatrists use a variety of methods to diagnose bunions. If there are symptoms present, podiatrists will first consider that it is a bunion. If not, a physical examination will be conducted to check function of the big toe. Finally, an X-ray may be taken to view the extent of the bunion and confirm it is a bunion.

Typically, nonsurgical methods are used to treat bunions, unless the bunion has become too misaligned. Orthotics, icing and resting the foot, roomier and better fitted shoes, taping the foot, and pain medication are usually utilized first. If the bunion doesn’t go away or causes extreme pain, surgery may be required. Surgeons will either remove part of the swollen tissue or bone to straighten the toe out.

If you have a bunion, it is recommended to see a podiatrist. The longer it is left untreated, the worse it may get. Podiatrists can properly diagnose and treat a bunion before it gets worse.